Hypoechoic Nodule or Complex Cyst Beneath Big Toe Joint

[AthenaM]

I finally received ultrasound results that I have a hypoechoic nodule or complex cyst attached to the small tendon beneath my big toe (between where the toe attaches to the foot and the round end of the toe).  It has caused me to walk off gait and my knee and hip are sore.  Also, my right big toe hurts more in this area than the left because I have put too much weight on this foot for four weeks.  From what I can find, the only way to treat this is surgery.  However, I am very concerned about damage to the tendon this cyst is attached to.  I am also very confused as to how this could have happened.  The only thing that I had done differently was walk on my tiptoes at night to be quiet for several weeks.  It seems it could have been caused by trauma?  I am very concerned as 13 years ago I had plantar fasciitis and RSD due to cortisone injections and too much physical therapy, taping etc.  There is definitely a mind-body "thing" here.  If anyone could tell me anything about cyst removal from beneath this toe joint and what could go wrong, I would greatly appreciate it - as well as how long it takes to be able to walk on it again as I live alone and have no one to help me.  Thank you.

[Yena H Do, DPM]

if you have this done by a competant surgeon, it shouldn't be a problem.  you have 2 tendons that attach to the toe that make the toe flex.  if one had to be sacrificed due to the surgery, you could still flex the toe with the other.  also, tendon trauma from surgery can always be repaired.  things that can go wrong:  infection, nerve trauma, healing complications.  cysts can arise from trauma and also arise without any insult to the area.

[Yena H Do, DPM]

there can be a recurrence if the entire cyst is not removed.  whether ortho or podiatry, go to someone you are comfortable with and trust.
i don't know what is being cut (what level the cyst integrated in) and what exactly is involved (the binding/attaching tissues involved), so i can't really tell you what the outcome would be.  
sorry about being vague.  good luck

[AthenaM]

I would really like areply to my most recent post.  Thank you.

[AthenaM]

I have been kept waiting for weeks by the podiatrist I visited.  He only spent two minutes with me and said I needed an ultrasound for the reason outlined in my original post.  Then, he said I might as well get an MRI because the insurance would cover it.  I tried to explain to him and his assistant that I would not be covered but they did not listen.  I thought about it over the weekend and talked to a few people and canceled the MRI.  I waited for an additional week waiting for this office to schedule the ultrasound.  They kept telling me that only certain hospitals did "toe ultrasounds".  I called the hospital I was familiar with and they said they could do it.  I told the podiatrist's office and they refused my request, saying that the hospital in question did not do this.  I called the hospital again and they again told me they would do it.  The woman in Radiology told me she would call the podiatrist's office and straighten out the matter.  She called me back and said we were at the mercy of the assistant.  As we were speaking, thankfully, the fax came through.  I did find out that she was treated no better than I had been.  This was on a Friday and I had the ultrasound the following Monday.  If I had waited for this podiatrist's office to schedule the ultrasound, I would still be waiting!  I had a copy of the results sent to my ob/gyn office because I didn't trust the podiatrist's assistant.  They called me with the results.  I had to email the podiatrist and it took him two days to reply with much less information than my ob/gyn office gave me!  I emailed him to please let me know when we could take care of this and no answer.  I called his office and no answer.  In the meantime, I called my ob/gyn office and asked for a referral to a podiatrist that they knew of eventhough I knew I would have to drive two hours.  I was able to schedule an appt. for next week after waiting over four weeks with the other office's less than professional service.  I even received a call from the doctor who I will see next week!  I told him all results would be sent to him prior to my appt. and he said he would give me all the info I need at the appt.  Later that evening, I finally received an email from the podiatrist who would never answer saying that he could not help me until the end of May and that due to my anxiety - I would not get through such an invasive procedure such as having this nodule removed!  In my opinion, this doctor is less than professional and the way he manages his practice is horrible.  I am posting hoping to hear from anyone who has received such treatment before.  I don't see that this is a highly invasive procedure eventhough a tendon is involved.  I won't write what I really think.  The doctor who I will see next week said  it is a simple procedure and that I will even be able to get around afterward.  If you can find a doctor that will put you at ease, it makes all the difference.  And, if you can deal with a staff that is efficient and kind - all the more difference.  I am appalled at how I was treated.  I have been made to wait for weeks when this all could have been taken care of at least two weeks ago.  I am disgusted at the health care providers that make it so difficult for us to trust anyone.

[AthenaM]

Thank you.  I really appreciate your input.  It sounds as though it is safer to do nothing.  I have no idea if the podiatrist/surgeon is competent and have no referrals.  I scar easily so I am afraid that if I had this removed, there would be complications.  I have no idea if it would be better for me to have an orthopedist or a podiatrist evaluate this more.  And, if I did have this removed, how can I prevent it from happening again?