This is a peculiar situation that presents to my clinic from time to time. The patient complains of a painful swelling over the top of the foot. This lump feels bony and can be “unsightly”.
A possible diagnosis is a ganglion. This is a fluid-filled sac arising next to the joint or tendon sheath.
However, in this case, the problem is bony bossing of the base of the bone of the foot (metatarsal bone).
A simple x-ray of the foot taken in the “true-lateral” view with clinch the diagnosis.
A zoomed in view:
The treatment can be avoiding tight shoes that presses onto the bony spur or surgically remove the bony spur.