Trauma and swelling on the top of the foot

[Miles213]

Hi- 3 weeks ago I injured the top of my left foot while practicing martial arts. The impact was on my sparring partners elbow. There was immediate swelling (golf ball sized) lump, tenderness and light pain. I used ice to reduce the swelling and rested it for some time. The pain dissipated and I now have full range of motion with hardly any discomfort at all. The only thing that is still present is some swelling in that area. There is still a lump/bump there that will not go away. Again, it is not painful, but I wonder if it could be a ganglionic cyst of some sort or something which needs to be aspirated. What do you think?

Also, the lump is roundish, as wide as a plum and fairly hard. No discoloration. It is about 1-1.5cm in height. It seems when I wrap it with an ace bandage the swelling gets diffused. ie, after I take the wrap off after wearing it for 8 hours there is hardly any swelling at all. Then it goes back to that area.

[Tom Plamondon PA-C]

Hello,
The lump or bump on top of your foot may indeed be a ganglion cyst (a sac filled with clear fluid usually attached to underlying muscle tendon shealth or joint capsule).
Ganglion cysts usually occur on the back of the hand or top of the foot and can be caused by trauma.
The treatment options are: treat the swelling and wait; aspirate the fluid; aspirate the fluid and inject with corticosteroid; or surgical removal of the cyst. Option two and three carry the same 50% rate of resolution. Ganglion cysts are notorious for returning so recurrent cysts should be considered for surgical removal.

Hope this helps. See your family physician for definite diagnosis and treaatment.

[Miles213]

Thanks for the input. I was given some information suggesting that it was a hematoma as opposed to a ganglion cyst. How can you tell the difference and which of the two would be more likely?

[Tom Plamondon PA-C]

Hello,
In the most basic sense, the difference between a hematoma and a ganglion cyst is the contents of the mass. Hematoma contains blood while ganglion cysts contains mucin (a clear fluid).

In the general population, ganglion cysts are more common than hematomas according to statistics. In the martial arts...the statistics may tell a different story of which I have not read or heard.

Keep us posted.