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Anything I should know about getting a cyst on my big toe removed? +MRI report

 

   


trichris

Mar 14, 11 10:57

Post #1 of 10 (5162 views)
Anything I should know about getting a cyst on my big toe removed? +MRI report Quote | Reply

The last 2 years I've been getting this pain in my right, big toe joint. It makes a cracking sound all the time when I walk. It feels stiff all the time. Range of motion is not normal. The problem intensifies into discomfort/pain/stiffness as walking continues(I'm really into hiking, so I'm talking about 4+ hour walking/hiking).

I recently saw a sports medicine podiatrist, Dr. Braver in Englewood NJ. He told me I should get the cyst drilled. Below is the report from my MRI.

I want to get healthy. What should I know?

I'm male, 25 years old.

Thanks!





MRI of the right foot.

History: Right forefoot pain.

Technique: Multiplanar sequences of the foot were acquired distal to the navicular bone.

Result: There is a small joint effusion of the first metatarsal phalangeal articulation and foot in the hallux S1 articulation. There is chondral thinning of the articular surfaces of the base of the proximal phalanx and first metatarsal head with joint narrowing. There are marginal osteophytes. There is subchondral edema with early cystic change in the central articular surface of the first metatarsal head. There is subchondral edema and early cystic change along the plantar and medial aspect of the first metatarsal head. The medial and lateral sesamoids are intact. The capsular ligaments are intact. The flexor hallucis longus and extensor hallucis longus tendons are intact.

There is a small joint effusion of the interphalangeal articulation of the first ray. The joint is maintained.

There is increased T2 signal of the marrow of the terminal phalanx of the great tow. This is associated with increased signal intensity of the splenic soft tissues on inversion recovery sequences. However, there is no evidence of marrow edema signal on the T1-weighted sequences and this finding is most likely due to the incomplete fat saturation of the soft tissues and bone. Similar findings are present within the distal phalanges of the second and third digits.

The metatarsal phalangeal and interphalangeal articulations otherwise are intact. There are degenerative changes at the MTP articulations with mild varus angulation at the fifth MTP articulation. There are no inflammatory changes appreciated. The flexor and extensor tendons are intact.

The visualized peroneal tendons are intact.

Tarsometatarsal line is maintained. The Lisfranc ligament is intact.


trichris

Mar 31, 11 9:55

Post #2 of 10 (5091 views)
Re: Anything I should know about getting a cyst on my big toe removed? +MRI report [trichris] [In reply to] Quote | Reply

Bump. Any thoughts?


trichris

May 3, 11 11:40

Post #3 of 10 (5011 views)
Re: Anything I should know about getting a cyst on my big toe removed? +MRI report [trichris] [In reply to] Quote | Reply

I'm getting a surgery tomorrow AM. The doc is going to try to keep it arthroscopy and not cut me open. He's going to remove the cyst and try to increase blood flow to get my cartilage smooth so I can get a nice range of motion going in the joint. Any thoughts???


kayano

May 3, 11 16:54

Post #4 of 10 (4968 views)
Re: Anything I should know about getting a cyst on my big toe removed? +MRI report [trichris] [In reply to] Quote | Reply

At such a young age this sounds reasonable. Unfortunately we don't have good cartilage replacement yet. Not sure about doing it arthroscopically as this is a relatively small joint with easy access thru traditional incision.That said Dr. Braver has an excellent reputation and would respect his opinion.


rroof

May 3, 11 17:46

Post #5 of 10 (4953 views)
Re: Anything I should know about getting a cyst on my big toe removed? +MRI report [trichris] [In reply to] Quote | Reply

Definitely a reasonable approach. Surprising MRI for your age (25!?). Did you ever have an injury to the area?
____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD


trichris

May 3, 11 17:54

Post #6 of 10 (4946 views)
Re: Anything I should know about getting a cyst on my big toe removed? +MRI report [rroof] [In reply to] Quote | Reply

Never had an injury to the area. I believe he said the x-ray showed my first metatarsal being a tad unusually short, which may be a reason for my problem.


trichris

Feb 14, 12 9:00

Post #7 of 10 (4307 views)
Re: Anything I should know about getting a cyst on my big toe removed? +MRI report [rroof] [In reply to] Quote | Reply

Last May & June he opened me up and shaved my metatarsals down, cleaned up the joints, and drilled at the cysts. Range of motion increased big time. I've had some good days and a lot of bad days. I'm in orthotics now. Over the past few weeks pain at the joints have been getting worse. I got x-rays and an MRI yesterday. I've got a bone cyst again in the same area in one foot. Today the doc said I have degenerative arthritis at the MTP joints. He gave me a cortisone shot in my one foot. I don't know what to do. It hurts walking. Not because of the shot, but because of the feet I have. I really want to start hiking the Appalachian Trail next month. In the past year I've had a bunch of pain free, long day hikes. I'm hoping the cortisone shot will get me back feeling 100%.


rroof

Feb 14, 12 9:16

Post #8 of 10 (4286 views)
Re: Anything I should know about getting a cyst on my big toe removed? +MRI report [trichris] [In reply to] Quote | Reply

I'm sure your corticosteroid inj will help some, but it isn't going to fix your problem. DJD of any joint doesn't go away, and unfortunatley, it generally gets worse over time. Since you are only 25-26, you will definitely be dealing with this for a long time. Does your orthotic have a stiff Morton's extension in it too limit 1st MPJ motion? You need to discuss your short/long term goals with your surgeon (i.e. hike the trail, running, etc.) and what your best options are. If the pain is stopping you from your activities of choice or even daily function, there are other options, but none of them great for young/active people (i.e. partial joint replacements, joint fusion, etc.).
____________________________________
Fatigue is biochemical, not biomechanical.
- Andrew Coggan, PhD


trichris

Feb 14, 12 10:53

Post #9 of 10 (4252 views)
Re: Anything I should know about getting a cyst on my big toe removed? +MRI report [rroof] [In reply to] Quote | Reply

26. He actually made them softer in that area cause it was aggravating the joints, which has helped. It was super-duper knife pain! He said I'm too young for replacements/fusion surgery.


sienkows

Jun 18, 13 19:32

Post #10 of 10 (2526 views)
Re: Anything I should know about getting a cyst on my big toe removed? +MRI report [trichris] [In reply to] Quote | Reply

Any updates on your recovery? I'm having similar toe pain at 36 and am considering surgery to "clean out the joint" according to the surgeon. I'm worried that it might make the pain worse...

   
 
 
 



Current-aided swims
Do swims aided by a current, such as the NYC Tri and the past weekend's IM Chattanooga, diminish the achievement? Or are they just a local geographic expression of multisport?
Diminish the achievement
Just the local geography