A ganglion cyst is a fluid-filled lump under the skin.
It is often found over a joint or in a tendon in the hand or wrist.
The ganglion cyst forms when there is a small tear (herniation) in the sleeve of thin tissue covering a joint or tendon.
The tissue bulges and forms a sac.
Fluid from the joint leaks into the sac and causes swelling.
Ganglion cysts are typically round or oval.
They can appear suddenly or slowly and can disappear on their own.
They can also reappear for no reason.
They vary in size, and in many cases, grow larger with increased activity. With rest, the lump typically becomes smaller.
Small ganglion cysts can be pea-sized, while larger ones can be around 2.5 centimeters in diameter.
Some cysts are so small that you can’t see them. They are known as occult ganglions
They can also be soft or firm.
They may or may not be painful.
When they occur on the back of the hand, they are called a dorsal ganglion cyst.
and when they occur on the palm side of the wrist,
they are called volar ganglion cysts.
No one knows exactly what causes a ganglion cyst to develop.
women are more likely to be affected than men.
between the ages of 15 and 40,
they can be seen in very young children.
These types of cysts also tend to develop more frequently in people who repeatedly stress their wrists,
repetitive wrist or finger activities.
Osteoarthritis.
Joints or tendons that have been injured.
Other types of tumors such as a lipoma or giant cell tumor,
carpal bossing which is a bone spur,and other conditions can cause lumps on hand and wrist.
A bump beneath the skin .
Ganglion cysts usually are painless.
But if a cyst presses on a nerve it can cause pain, tingling, numbness or muscle weakness.
the doctor usually diagnoses ganglia by physical examination.
A lump’s appearance and location are telltale signs of ganglia.
the doctor may press on the bump to see if it painful.
The cyst should not adhere to the skin, and the skin should have a normal color.
hold a light source, such as a small flashlight, against the cyst.
A normal ganglion cyst will trans-illuminate, meaning light will pass through the cyst indicating it is not a solid mass.
radiological studies are typically not necessary,
but some doctors will obtain an X-ray just to ensure the anatomy and structure of the hand and wrist is normal.
X-rays will not show a ganglion cyst, but they may show other problems,
If there is a question about if the bump is a cyst or something else, imaging tests including ultrasound or MRIs can be helpful.
Ganglion cysts often go away without treatment.
If the cyst doesn’t cause pain or discomfort, treatment isn’t necessary.
Anti-inflammatory medication may minimize swelling, easing mild levels of discomfort.
Splints or braces offer support and stop you from moving the affected area, reducing swelling and pain.
For patients with bothersome symptoms,
an aspiration of the ganglion cyst is suggested. the fluid is drained from it.
However, the patient should be informed that more than half of ganglion cysts treated with aspiration will recur within approximately one year.
because the root or connection to the joint or tendon sheath is not removed.
Aspirations are most often attempted for ganglions located on the top of the wrist.
Ganglions on the palm side of the wrist can be tricky to aspirate due to their proximity to major vessels and nerves.
In our experience, if the cyst recurs rapidly within two to four weeks after the first aspiration,
a second aspiration is unlikely to be successful.
However, if the cyst recurs after a longer period of symptom relief (closer to one year),
another aspiration may be attempted.
We do not recommend injection of ganglion cysts with cortisone based upon evidence that there is no added benefit,
and there is a potentially increased risk of subcutaneous fat atrophy and skin depigmentation.
closed rupture of ganglion cysts on the dorsum of the wrist using hard tools, like a book or a coin,
is generally thought to be unreliable and is not a recommended treatment modality.
It’ll work very temporarily, but the cyst will almost certainly come back.
And each time it is smashed,
you get internal bleeding and scarring. This makes the other options more difficult, and less likely to work in the future.
Your doctor may recommend surgery to remove the cyst if your symptoms are not relieved by nonsurgical methods, or if the ganglion returns after aspiration.
Surgery involves excision of the cyst along with its stalk.
This may mean excising part of the involved joint capsule or tendon sheath to ensure removal of the root of the cyst.
Even after excision, there is a small chance the ganglion will return.
if not properly removed, the ganglion may recur postoperatively.
Approximately 10 percent recur with surgery.
You are usually able to resume normal activities 2 to 6 weeks after the procedure.
5 ноя 2022
