Pseudotumour of the foot due to hypermobility of the first ray

A patient presenting with a chronic mass secondary to hypermobility of the first ray was successfully treated with a modified Lapidus procedure combined with a lengthening of the Achilles tendon. The association of the pseudotumour with a synovial cyst secondary to instability of the first ray was only made after appropriate weightbearing radiographs. The patient had previously been offered an amputation due to recurrence of the cystic mass after surgical excision. This case illustrates the importance of weightbearing radiographs in the assessment of the foot and the ankle disorders.