--- title: Why does this 11-year-old have a moving toe lump? description: Why does this 11-year-old have a moving toe lump? image: https://info.medality.com/hubfs/Imported_Blog_Media/11-Toe-Updated-1-300x300.jpg --- [![ProScan-MRIONLINE-LOGO](https://info.medality.com/hs-fs/hubfs/LOGOS/ProScan-MRIONLINE-LOGO.png?width=1470&name=ProScan-MRIONLINE-LOGO.png "ProScan-MRIONLINE-LOGO")](https://mrionline.proscan.com) - [Knee](https://info.medality.com/topic/knee) - [MSK](https://info.medality.com/topic/msk) ## [How should you approach this 24-year-old's knee case?](https://info.medality.com/proscan-case-review/msk/approach-24-year-olds-knee-case) **Sam Wilson** | Oct 20, 2017 12:32:37 PM This 24-year-old reports for a knee MRI. She reports no injury, but her knee is misaligned and pain is worse with activity. ![ProScan Education](https://info.medality.com/hubfs/Imported_Blog_Media/11-Toe-Updated-1-300x300.jpg "ProScan Education") - [Foot](https://info.medality.com/topic/foot) - [MSK](https://info.medality.com/topic/msk) - [Pediatric](https://info.medality.com/topic/pediatric) ### [Why does this 11-year-old have a moving toe lump?](https://info.medality.com/proscan-case-review/msk/11-year-old-moving-toe-lump) - [**](https://www.facebook.com/sharer/sharer.php?u=https%3A%2F%2Finfo.medality.com%2Fproscan-case-review%2Fmsk%2F11-year-old-moving-toe-lump) - [**](https://www.twitter.com/share?url=https%3A%2F%2Finfo.medality.com%2Fproscan-case-review%2Fmsk%2F11-year-old-moving-toe-lump) - [**](http://www.linkedin.com/shareArticle?mini=true&url=https://info.medality.com/proscan-case-review/msk/11-year-old-moving-toe-lump) [All Posts](https://info.medality.com/all) # Why does this 11-year-old have a moving toe lump? - [Tweet](https://twitter.com/share) This 11-year-old female presents with a lump on the third digit of her foot that has been present for more than a year. The lump is mobile on exam, and is not growing or causing pain. She has no history of surgery or trauma. Evaluation of masses of the extremity usually begins with plain radiographs (not available in this case). What is the diagnosis? What are some of the advantages of MRI vs. plain films in cases of extremity masses? ![](https://info.medality.com/hs-fs/hubfs/Imported_Blog_Media/11-Toe-Updated-1-300x300.jpg?width=300&height=300&name=11-Toe-Updated-1-300x300.jpg) Coronal STIR ![](https://info.medality.com/hs-fs/hubfs/Imported_Blog_Media/11-Foot-Updated-2-300x300.jpg?width=300&height=300&name=11-Foot-Updated-2-300x300.jpg) Sagittal STIR ![](https://info.medality.com/hs-fs/hubfs/Imported_Blog_Media/11-foot-Updated-3-1-300x300.jpg?width=300&height=300&name=11-foot-Updated-3-1-300x300.jpg) Axial STIR The cause of this patient's lump is a ganglion cyst (pseudocyst). A ganglion is really a pseudocyst that occurs because a capsule or tendon sheath is deficient or has a "microtear." Fluid diffuses into the surrounding soft tissues where it is walled off by fibrous tissue. Ganglia exhibit **NO** epithelial lining like a true cyst. The origin of the ganglion might be seen as a small "tail" or "nubbin" from whence it came. A rarer diagnosis would be epidermoid or cystic schwannoma. The green arrows demonstrate small intertarsal bursal cysts (image 3). Otherwise, her foot is normal. The advantage of MRI vs. plain radiography is that MRI provides for soft tissue resolution and is helpful in discriminating among cartilaginous lesions, osseous lesions, muscular or tendon-slip lesions, and other connective tissue lesions. Plain films have a cost advantage and can exclude bone lesions such as fracture or osteochondroma. But, near to the trunk of the body, avoid any x-ray or radiograph in persons of childbearing age when you can. Substitute ultrasound or MRI. For more case review, check out [MRI Online](http://mrionline.proscan.com/p/medical-imaging-quick-hits). [gravityform id="4" title="true" description="true"] ###### ABOUT THE AUTHOR | Sam Wilson ![](https://cdn2.hubspot.net/hub/2558854/hubfs/DreamPack/letter%20Icon.png?t=1496817989590&width=86&name=letter%20Icon.png) ## Subscribe Subscribe now and receive a box filled with hand-picked awesome items ** #### Subscribe to our newsletter [![Subscribe](https://no-cache.hubspot.com/cta/default/4177793/653661e3-b12d-49b7-9400-e30973dd9f99.png)](https://cta-redirect.hubspot.com/cta/redirect/4177793/653661e3-b12d-49b7-9400-e30973dd9f99) ![](https://info.medality.com/hs-fs/hubfs/knee-guide.jpg?width=240&name=knee-guide.jpg) ### Landing Pages: The Do’s and Dont’s Improve your forms, page structure and overall leads. Fusce dapibus [![Get Your Copy](https://no-cache.hubspot.com/cta/default/4177793/795b3b16-192b-42dd-9cda-7df4fba5a6c9.png)](https://cta-redirect.hubspot.com/cta/redirect/4177793/795b3b16-192b-42dd-9cda-7df4fba5a6c9) Recent Posts - [Knee](https://info.medality.com/topic/knee) - [MSK](https://info.medality.com/topic/msk) ## [How should you approach this 24-year-old's knee case?](https://info.medality.com/proscan-case-review/msk/approach-24-year-olds-knee-case) #### This 24-year-old reports for a knee MRI. She reports no injury, but her knee is misaligned and pain is worse with activity. 1. What do you call the ty... 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[Read more](https://info.medality.com/proscan-case-review/msk/39-year-old-man-lump-finger) - [Foot](https://info.medality.com/topic/foot) - [MSK](https://info.medality.com/topic/msk) - [Pediatric](https://info.medality.com/topic/pediatric) ## [Why does this 11-year-old have a moving toe lump?](https://info.medality.com/proscan-case-review/msk/11-year-old-moving-toe-lump) #### This 11-year-old female presents with a lump on the third digit of her foot that has been present for more than a year. The lump is mobile on exam, an... 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