Hygroma Of The Foot - Causes, Symptoms And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Hygroma of the foot

Hygroma of the foot is a circular cystic formation that is located under the skin. Inside, it is filled with jelly-like contents. The membrane of the hygroma is represented by connective tissue. This is a benign tumor that does not have the ability to degenerate.

The hygroma of the foot occurs from the tendon sheaths, or has a connection with the articular capsule. Therefore, the tumor is always located in the immediate vicinity of the joints.

Most often, people develop a hygroma of the wrist joints. In the area of the feet, tumors form less frequently. They can be located on the dorsum of the metatarsus or toes, or on the anterior outer surface of the ankle.

Although hygromas are not malignant, they can become inflamed and sore. Most often this occurs due to excessive friction of the tumor on the shoes, or when it is injured. Therefore, they should not be ignored. The sooner the hygroma is removed, the faster the tissue repair process will go.

Content:

• Causes of foot hygroma
• The mechanism of formation of foot hygroma
• Symptoms of foot hygroma
• Complications of foot hygroma
• Diagnostics of the foot hygroma
• Treatment of foot hygroma
• Prevention of foot hygroma

Causes of foot hygroma

Until now, doctors cannot identify all the factors that influence the formation of a hygroma. However, some of the reasons leading to its development are known.

These include:

• Inflammation of the joints or tendons of the lower extremities.
• Genetic predisposition to the formation of a hygroma. It has been established that such tumors appear more often in blood relatives.
• Daily intensive loads on the foot. At risk for the formation of a hygroma of this localization are people of such professions as: loaders, athletes, teachers, salespeople, etc.
• Injuries to the tendons and joints of the foot. After receiving a single injury, hygromas form in 30% of people.
• Wearing uncomfortable shoes that press or chafe the leg, injuring the tendon. In women, foot hygroma can appear if she constantly wears high-heeled shoes.
• Flat feet. In this case, a hygroma can form on the sole. The arch of the foot in such people is poorly developed, and the tendons are constantly injured.

In general, being a female is a risk factor for the formation of a hygroma. In men, such tumors are formed 3 times less often.

The mechanism of formation of foot hygroma

The mechanism of formation of a hygroma is as follows:

• The tendon sheath or joint capsule is exposed to a pathological factor. Their cells are reborn.
• A capsule forms in the affected area. It is represented by metaplastic cells of the connective tissue: fusiform and spherical.
• Fusiform cells form the capsule shell, and spherical cells fill with fluid. It goes out into the intercellular space and fills the tumor.
• Hygroma grows and develops, begins to put pressure on the blood vessels and nerve endings.

If the hygroma is removed in time, then complications such as pain, inflammation and deterioration of tissue nutrition can be avoided.

Symptoms of foot hygroma

In past years, the hygroma was called the tendon ganglion, so this term is still found in the medical literature. A tumor forms near the serous bursa of the joint. The hygroma itself has no nerve endings, but it can exert pressure on the nerve fibers that are located in the surrounding tissues.

Hygroma can be soft, elastic, or hard. It all depends on the concentration of fibrin and mucus that fill the tumor. The harder the hygroma, the more discomfort it gives to a person.

Hygromas are prone to constant growth. They are slowly increasing in size. The average tumor diameter is equal to 3 cm, although sometimes it can reach 6 cm or more.

For a long time, the hygroma may not manifest itself in anything. Pain occurs as a result of her injury, or pressure on nerve fibers. Most often, the tumor is single, but sometimes several cysts form in the area of the joint and tendon.

The main symptoms of foot hygroma are as follows:

• The presence of a subcutaneous tumor that has clear contours. When pressed, it is soft, elastic or stiff.
• The tumor has poor mobility, since it is connected to the tendon, or to the synovial bag of the joint.
• The skin is not changed, pain is often absent.
• If the hygroma is located in the immediate vicinity of the nerve fibers, or begins to put pressure on them as it grows, the person will experience discomfort.

Hygroma, located on the plantar part of the foot, have a dense structure, they are motionless. These tumors are often confused with bony growths.

Complications of foot hygroma

If the vessels supplying the lower limb turn out to be pinched, then this leads to complications such as:

• Deterioration of the sensitivity of the foot. In this case, the part of the leg that is located below the place of compression will suffer.
• The feeling that "goosebumps" are crawling down the leg. The foot may tingle.
• The appearance of pain of the "lumbago" type.
• Deterioration of the blood supply to the foot. At the same time, her skin becomes dry, thinned. Toenails may begin to deteriorate.
• Due to a lack of nutrients, pustular rashes may appear on the skin.
• If the veins of the limbs are pinched, the legs will begin to swell.
• If the vessels are strongly compressed, then the foot changes color, it may become cold to the touch.
• Local inflammation develops when shoes press on the hygroma. Therefore, a person has to choose the most spacious pairs. If this condition is not observed, then the patient may develop tendovaginitis or bursitis.

If the hygroma is located on the sole, then it will be constantly injured. These tumors should be dealt with as quickly as possible.

Diagnostics of the foot hygroma

Diagnosis of foot hygroma is not difficult, since this neoplasm has its own characteristic features.

However, the differential diagnosis must be carried out with such pathologies as:

• Lipomas.
• Atheromas.
• Bone or cartilage tumors.

To clarify the diagnosis, the doctor will refer the patient to an ultrasound examination. This method allows you to visualize the cyst, assess its structure, check for the presence of blood vessels in it, etc.

If the doctor still has doubts about the benign quality of the neoplasm, then the patient is referred for an MRI. This highly informative method allows you to clarify the presence of nodes in a hygroma and evaluate its contents.

Another diagnostic method is tumor puncture. The doctor punctures it with a syringe, and then takes the contents of the hygroma. In the future, he is sent for a histological examination, which allows to determine the presence of malignant cells in the exudate.

Treatment of foot hygroma

It will not be possible to cure the hygroma on its own. To get rid of a neoplasm, you need to contact one of the specialists: an orthopedist, surgeon, traumatologist. After the examination, the doctor will decide on the tactics of managing the patient. It is important not only to remove the hygroma, but also to direct efforts to eliminate the causes of its occurrence. Patients with flat feet will have to wear orthopedic shoes, women will have to refuse to buy high-heeled shoes. If a person has tenosynovitis or bursitis, then these diseases are subject to therapeutic correction.

Conservative treatment of foot hygroma

Conservative treatment methods do not allow you to cope with the hygroma. It was experimentally found that after any manipulations with the tumor, with the exception of surgical intervention, it recurs again.

In past years, they tried to remove the neoplasm using methods such as:

• Puncture. At the same time, the hygroma will necessarily recur in the future, since the cells producing fluid are part of its shell, and it remains inside the tissues. Puncture for therapeutic purposes is used in the current conditions, but it is done only if a person has contraindications for surgery, and the hygroma worsens his quality of life, for example, greatly interferes with walking.
• Introduction to the hygroma of steroids and sclerosing drugs. This method is dangerous because such medications can get on healthy tendon or joint tissue and cause inflammation.
• Kneading and crushing the tumor. This is a dangerous and ineffective method of its treatment, which in 100% of cases leads to a relapse.
• Physiotherapy. UHF, salt baths, electrophoresis with iodine are used. These methods do not allow you to cope with the hygroma. With their help, you can only reduce the inflammation of the surrounding tissues, if any. Thus, physiotherapy is only a preparatory stage before the operation to remove the hygroma.

With suppuration of the tumor, antibiotics are used, but surgical intervention is a prerequisite in this case. Antibiotics are used both before and after surgery.

Surgery

An operation to remove a hygroma is a routine procedure if there is no purulent inflammation.

The indications for its conduct are:

• Developing complications of hygroma.
• Rapid increase in tumor size.
• Constant pain in the foot area.
• Cosmetic defect.
• Limitation of range of motion in the ankle joint.
• Patient discomfort while walking, difficulty in walking.

Relapse after surgery is rare, no more than 8-20% of cases. The procedure is performed under local anesthesia. However, if the cyst is large, or located in deep tissue structures, for example, under the tendon, then the patient is sedated.

The surgeon uses a scalpel to make an incision in the skin, and then carefully separates the hygroma from its base and surrounding tissues. Then the wound is sutured, covered with a sterile bandage, and the limb is immobilized. The plaster splint can be removed 7-10 days after the operation.

If the hygroma of the foot is located in the immediate vicinity of the nerve trunks and blood vessels, then the operation is performed using a laser beam. This method allows you to bleed the treatment area. The likelihood of infection is minimal, since the procedure is performed at high temperatures.

Features of rehabilitation

Since hygromas have a connection with the synovial sheaths and joints, all medical measures must be followed so as not to provoke a deterioration in their functioning. Excessive scar tissue formation can impair foot mobility.

To avoid such consequences, you should adhere to medical recommendations:

• Wear an immobilizing bandage for at least the period indicated by the doctor.
• Perform simple gymnastic exercises starting from 2-3 days of intervention.

• Attend physiological procedures aimed at tissue repair. The doctor may recommend electrophoresis, magnetotherapy, ultrasound treatment.

  If you follow these recommendations, then the likelihood of developing postoperative complications is minimal.

Prevention of foot hygroma

To prevent the formation of a hygroma, the following recommendations must be observed:

• Refuse to wear tight shoes.
• Do not wear high-heeled shoes.
• Perform foot massage after excessive stress on them.
• Treat all diseases of the joints and tendons in time, if they develop.
• Minimize situations in which a person can be injured.

People with a hereditary predisposition, as well as women, should be especially alert in terms of the formation of a hygroma.

The author of the article: Bykov Evgeny Pavlovich | Oncologist, surgeon

Education: graduated from residency at the Russian Scientific Oncological Center. N. N. Blokhin "and received a diploma in the specialty" Oncologist"