Question
QUESTION: Dear Dr. Katz:  About 10 weeks ago, I began experiencing pain through the mid-section / left side of my left foot.  I went to a Podistrist who x-rayed my foot and diagnosed me with Cuboid Dislocation Syndrome.  He taped my foot for 5 weeks without improvement.  I acquired a second opinion from an Orthopedic Surgeon who x-rayed my foot and (from my symptoms) --> diagnosed me with a possible stress fracture and ordered a MRI.  I have now received the MRI results today which showed no fracture; but actually showed a cyst at the base of the 5th metatarsal.  I am now walking around in a post-op shoe to try and minimize the pain.  Could you advise me on best possible treatments, alternative treatments, possible outcomes, etc.).  Thank you very much.  I really appreciate your time.
Bart

ANSWER: Hi Bart,

The pain in your foot is likely the result of the cyst expansion.  It may be compressing a nerve on the side of the foot.  I would consider drainage of the cyst with possible injection of cortisone into the cyst.  In some cases the cyst may need to be removed surgically from the foot.  I have performed cryosurgery on the cysts, freezing them and the associated nerve, however, in any case there is a fair chance of recurrence.  I would see a podiatrist that deals with these types of problems.  You will likely need more than just a surgical shoe for relief of your foot pain.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com



DISCLAIMER:
This information is offered as free advice and as general information. It may not be applicable to the specific questioner and his/her problem.  It is not based on actual knowledge of the questioner or his/her medical history and it cannot and should not be relied upon as definitive medical opinion or advice.  Reliable medical opinion and advice can only be obtained through hands-on physical contact and exam of the patient to establish an accurate diagnosis and treatment plan.  No doctor/patient relationship is created or established here and may not be inferred through answers on this site.  The questioner and other readers must consult his/her own doctor before proceeding or implementing any suggestions contained within this document and answers on this site.  The questioner is only to act upon his/her own doctor抯 orders and recommendations. By reading this posting which follows, the reader fully understands and confirms that he/she holds harmless this writer. If this is not fully agreeable to you, the reader, and/or you have not attained the age of 18 years, you hereby are advised to read no further.

---------- FOLLOW-UP ----------

QUESTION: Dr. Katz:  Thanks so much for your response.  I really appreciate it.  --However, since I sent you my first e-mail question, I have since seen my Orthopedic Surgeon again and he informed me that the cyst was 2-3 mm in diameter and was called a intraosseous cyst within the base of the fifth metatarsal.  When I asked him what was the recommended treatment he responded with 揟here is nothing to do about this type of cyst.  It is in the bone and too small to be causing your pain.? I asked him again if we could drain it or get rid of it with surgery and he said 揟here is nothing that he could do for this type of cysts.  The cyst is not infected or cancerous. Sorry?  
--My original Podiatrist diagnosed me with Cuboid Symdrome.  Do you think this is what I might have since I do still have severe pain while walking (like I have a broken bone) directly in the Cuboid Joint but no one can find anything wrong with me?  I am seeing an acupuncturist and massage therpist and they do relieve some of pain (however their pain refief is temporary).  
-So now where do I go from here?  
-Very frustrated in San Diego.
Sincerely,
Bart O.  

Answer
Hi Bart,

This cyst in the metatarsal is very small and is not something that can be drained.  Your source of pain could be due to the tendon that attaches to the base of the 5th metatarsal.  Also, severe pain in this area may be caused by the nerve branch that goes to the side of the foot. Some get relief with an injection of cortisone.  I treat these types of pains with cryosurgery if I can prove that the nerve is the pain source.  I would consider seeing another podiatrist for a new opinion.  Check out the site below for cryosurgery.

Good Luck.


Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com



DISCLAIMER:
This information is offered as free advice and as general information. It may not be applicable to the specific questioner and his/her problem.  It is not based on actual knowledge of the questioner or his/her medical history and it cannot and should not be relied upon as definitive medical opinion or advice.  Reliable medical opinion and advice can only be obtained through hands-on physical contact and exam of the patient to establish an accurate diagnosis and treatment plan.  No doctor/patient relationship is created or established here and may not be inferred through answers on this site.  The questioner and other readers must consult his/her own doctor before proceeding or implementing any suggestions contained within this document and answers on this site.  The questioner is only to act upon his/her own doctor抯 orders and recommendations. By reading this posting which follows, the reader fully understands and confirms that he/she holds harmless this writer. If this is not fully agreeable to you, the reader, and/or you have not attained the age of 18 years, you hereby are advised to read no further.