Ganglion Suspected- Adult Leeds

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1.  Information Resources for Patients and Carers

Quick info:

Patient information

Please see attached patient information leaflet on sprained ankle. Please see attached patient information leaflet on plantar fasciitis.

Please see attached patient information leaflet on achilles tendinopathy.

Please see attached patient information leaflet on Morton's Neuroma.

Please see attached patient information leaflet on hallux rigidus.

Please see attached patient information leaflet on hallux valgus. Please see attached patient information leaflet on ganglions.

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2.  Referral Forms

Quick info:

Referral Forms:

Mail Merged

The forms below are provided as a repository. They can be downloaded to your computer and be imported to your clinical system. This is so all practices have access to the most up to date forms.

EMIS - merged
MSK7 Foot Ankle V3
MSK 8 Specialist Foot Management V3
MSK14 Problem Not on Pathway Form V3

SystmOne - merged
MSK7 Foot Ankle V3
MSK 8 Specialist Foot Management V3
MSK14 Problem Not on Pathway Form V3

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3.  Ganglion Suspected

Quick info:

GP information

A typical ganglion may arise from the top of the foot or around the ankle. These cystic swellings arise from a tendon sheath or joint capsule. They should move freely under the skin, and trans-illuminate when a pen-torch is pressed against it.

If there is any clinical doubt, such as irregularity of the lesion, or a solid, immobile feel, it is appropriate to refer for an ultrasound scan to clarify the diagnosis.

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5.  Ganglion Confirmed

Quick info:

Patient information

Please see attached patient information leaflet on ganglions.

GP information

Most ganglions will cause no symptoms other than a noticeable lump. If the ganglion causes no pain and does not interfere with walking there is no indication for treatment. Advice to wear shoes that do not rub against the cyst may be all that is required.

If the ganglion causes symptoms such as mechanical irritation from rubbing, or a dull ache or tingling from pressure against the tendon sheath, joint capsule or local nerve, then the first treatment option to consider should be aspiration. If local expertise exists in the GP surgery then this can be performed in-house. If not, referral to the MSK-MDT for aspiration is appropriate.

Following aspiration some ganglions will recur. If the ganglion recurs after aspiration but causes no symptoms, reassurance is all that is required and no further treatment is indicated. If the ganglion recurs and causes symptoms once again, a referral can be made to the Clinician Matching System. Please do not refer patients unless they are sure they wish to have surgery.

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11. Aspirate - Refer MSK-MDT Referral Form (MSK7)

Quick info:

Referral Forms:

MSK7 Foot Ankle V3

Choose and Book

You can find this clinic on Choose and Book under:

Speciality: Orthopaedics

Clinic Type: Foot and Ankle Pain

Provider information

The only provider of the MSK-MDT clinic in the city is the Leeds Musculoskeletal Service. This is a multiprofessional clinic including senior physiotherapists and musculoskeletal physicians.

This clinic provides diagnosis, investigation, treatment and onward referral if needed.

This service is directly bookable via Choose and Book. Please complete the appropriate form and send via Choose and Book.

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13. Refer to MSK-TAS (Telephone Assessment Service) Form (MSK14)

Quick info:

Referral Forms:

MSK14 Problem Not on Pathway Form V3

Choose & Book

You can find this clinic on Choose & Book under:

Speciality:Orthopaedics

Clinic Type:Foot & Ankle

The MSK Telephone Assessment Service (MSK-TAS) is offered as a way of ensuring patients get into the right clinic when it is not clear from the pathways what the right course of action is.

This is distinct from the Diagnosis Unclear Pathway which is there to offer quick access to diagnostic assessment when patients present with symptoms that don't immediately fall into a diagnostic group.

Patients who are appropriate for the MSK-TAS fall into two categories:

Those who have a clear problem but there is no Leeds pathway and so you are ensure of where to refer the patient.

Those with a clear problem and course of action but you are unable to make the referral because of referral restrictions  caused by some pathways still not allowing GPs to directly refer to the appropriate surgeon.  Pathways where these restrictions  still occur are the Shoulder I Elbow, Spine, Knee and Foot I Ankle.

When you book the patient into the MSK-TAS via Choose & Book you are booking them a telephone  appointment.

Once the referral form has been completed and sent via Choose & Book a senior Physiotherapist will review the referral form within

48 hours. They will then decide the appropriate course of action and the patient will be contacted by phone at the allotted time in order to make the necessary  arrangements for onward referral.

Key Dates

Published: 09-0ct-2015, by Leeds
Valid until: 17-Jun-2016

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