Paraplate Cyst

Paraplate cysts or plantar plate ganglia represent small defects within the plantar plate of the metatarsophalangeal joint of the toe. These defects allow a small amount of joint fluid to extend through this crevice and form an encapsulated cystic structure adjacent the joint capsule. This is a similar process to parameniscal cysts of the knee and as such, we like the term paraplate cysts to describe these structures.

These cystic masses are common and often incidentally identified on the 4th and 5th toes.

Rarely are they cause of symptoms

However, when they are firm and sit on the plantar surface of the foot, they can irritate the plantar fat pad.

The other occasion where they can cause symptoms, is when they protrude laterally and provide an extrinsic compression force on the interdigital nerve. This can cause a focal compressive neuropathy and resultant irritation of the interdigital nerve. Symptoms are often similar to those of a Morton’s neuroma. An ultrasound guided de-bulking/aspiration injection often decompresses this cyst and resolves these symptoms.