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40 ish year old female with pain in the 2-4th toes left foot.
Original Dx was a Morton's neuroma and treated with Cortisone injections and orthotics.
When she failed to respond she obtained another opinion. At this time she also noticed some "swelling" in her ankle area.
A DxUS was done and a Dx of ganglion was made.
The patient at that point was referred to me for Surgical excision.
Approx. 4 cc's of fluid was aspirated and her symptoms completely resolved for two months when her cyst refilled. Another aspiration yielded the same results.
Surgery was then carried out.
The cyst was indeed intra tarsal tunnel coming of the flexor tendon sheath and adhered to the Posterior Tibial nerve.
Here are some intra operative photos.
Fellow American College of Foot & Ankle Surgeons
Board Certified Foot & Ankle Surgery, ABPS
Adjunct Professor OCPM
Green Bay, Wisconsin, USA