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Patient with painful cysts/bumps

Discussion in 'General Issues and Discussion Forum' started by SarahR, Jul 17, 2017.

  1. SarahR

    SarahR Active Member

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    I have a 58 year old male patient who started developing focal lesions that swell up over night and resolve over 4-5 days. He reports it feels better if he walks through the pain, they feel better warmed up vs cold. He recently had one in the deep layers of the right foot, had pain in the midtarsal area and plantar arch. Maximal supination of the foot relieved pain. Pain is burning type when lesions are swollen.
    On his exam he had a small bump on his right fourth extensor digitorum longus tendon. It wasn't terribly bad.
    This has been going on for the past 7 years, of course by the time he gets into anyone, sees doctors, arranges ultrasounds, the lesions are pretty much resolved so nothing remarkable is seen.
    His GP says ganglion cysts.
    Has anyone seen any similar cases, any recommendations for management /diagnosis?
  2. blinda

    blinda MVP

    Hi Sarah,

    From your description, they don`t sound like ganglion cysts. Are the lesions epidermal, dermal or subcu? Are they firm or soft to palpate? What is the full medical, familial, occupational history of this fella? Any chance of a pic? Sorry for all the questions, but we need a bit more info.

  3. SarahR

    SarahR Active Member

    No photos. The lesions were pretty well all resolved other than the small mobile bump on the tendon mentioned above.

    He hasn't been able to coordinate appointments or an imaging scan with a flare up with previous medical providers, and he hasn't had a flare since he attended first appointment with us as we would book him in an urgent slot to view them same day.

    Medical history of osteoarthritis in knees and shoulder, has been through full body scan with no findings regarding the lumps. Hypertension. Otherwise unremarkable. No reported history of autoimmune or allergic tendencies.

    He works a desk job and umpires baseball, plays hockey golf and works out cardio/weights a few times a week at the gym.

    Neurological and vascular were unremarkable. Biomechanical mechanical concerns are mild (low level of supination resistance), of a level would be addressable by off the shelf level supportive insoles and/or supportive footwear.

    The l

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