Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Everything that you are ever going to want to know about running shoes: Running Shoes Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
  2. Have you considered the Critical Thinking and Skeptical Boot Camp, for taking it to the next level? See here for more.
    Dismiss Notice
  3. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

Bursting Plantar Fascia Cysts?

Discussion in 'Biomechanics, Sports and Foot orthoses' started by RobinP, Apr 26, 2010.

  1. RobinP

    RobinP Well-Known Member


    Members do not see these Ads. Sign Up.
    I have very little of the medical information on this particular patient,only what I have been told by the patient.

    Patient is a keen runner and has been suffering from "rupturing cysts" in the plantar fascia. Her description is of a 2 week period of build up of pressure in the arch. When running downhill, there is a bursting sensation and the foot feels wet. Nothing is wet when the socks are removed but the patient can feel fluid in the arch of the foot.

    Her orthopaedic surgeon has had MRIs which apparently has shown up some types of cysts on the plantar fascia. He has already done bilateral plantar fascia releases - not sure what exactly was done.

    A very brief examination shows midfoot equinous bilaterally. No obvious swellings in the arch. There is no tenderness on palpation of the area of rupture. There is excessive pronation at and after midstance.

    At the present moment, treatment is on hold until I have some type of diagnosis. However, I have not found anything on my searches here and on google. I wondered whether anyone had any ideas for differential diagnoses?

    Many thanks in advance for any input

    Regards,

    Robin
     
  2. Robin might be good to have a few pics (MRI slides). You might get some better info ?
     
  3. RobinP

    RobinP Well-Known Member

    Hi Mike,

    I have no access to MRIs or to have them done. Same for radiographs. Reliant on reports passed on to me. I can see people have viewed this thread with little feedback. I suspect it is a combination of insufficient info and unusual presentation. Not surprised really, I was just hoping for the stroke of luck that someone else had come across something similar from my rather inept description!

    Regards,

    Robin
     
  4. drsarbes

    drsarbes Well-Known Member

    My guess is that when the fasciotomies were done perhaps the surgeon got a bit deep and interfered with one or more flexor tendon sheaths - as a result ganglion formation would likely occur. In this location it would be plausible that repetitive stress from running might burst these. Upon self-repair, the cycle would begin again.

    Steve
     
  5. RobinP

    RobinP Well-Known Member

    Thanks for the suggestion Steve. Any suggestions for treatment apart from reducing the stress on the flexor tendons by accommodating the midfoot equinous?

    Robin
     
  6. drsarbes

    drsarbes Well-Known Member

    Tx:
    Well, my advice is to verify your Dx first.
    If they are, in fact, ganglions, you always have the option of leaving them.
    If you can identify where they are attached (which tendon sheath for instance) you can
    possibly come up with biomechanical Tx.

    Excision would depend on her symptoms. To be honest, I can't recall seeing a ganglion in this area -
    which I assume from your description is plantar-central and deep. The tendon sheaths of all three tendons in this area are quite substantial.

    Steve
     
  7. RobinP

    RobinP Well-Known Member

    Thanks Steve,

    Going to get in touch with the orthopod who did the original fasciotomy and request further MRIs to get a better idea. Depends on whether the insurance company will pay out for them!
    Will update when I have more info.

    Regards,

    Robin
     
  8. RobinP

    RobinP Well-Known Member

    In case anyone is still interested, the patient has been referred to foot ankle specialist for further investigation. Never managed to get more info on the MRIs. However, I found this interesting case study posted by Kevin Kirby on another thread for chronic exertional compartment syndrome. I have passed it on to the foot ankle surgeon who will be seeing the patient

    Many thanks to Kevin

    Robin
     

    Attached Files:

  9. drsarbes

    drsarbes Well-Known Member

    Hi Robin:
    thanks for the followup.
    Your description (other than a bursting sensation) does not really fit a compartment syndrome. These continue to be symptomatic with activity.
    If you do happen to get an MRI result it would be interesting to hear what the findings were.
    Steve
     
Loading...

Share This Page