A ganglion (Greek: knot of tissue) cyst is a bump or mass that forms under the skin. They can occur at any joint or tendon sheath, but most often on the back of the wrist or on the fingers. Ganglion cysts are probably the most common lumps that occur in the hand. Most often, ganglion cysts occur in the 25-45 year old age group, and they are more common in women than they are in men. Ganglion cysts are benign tumours (so do not spread to other body areas), and their cause is unknown. Sometimes they are also called synovial hernias or synovial cysts because of their relationship to the synovial cavities in the joint. Also known as subchondral cysts.
Anatomy and physiology
Ganglion cysts are thin, fibrous capsules containing a clear, mucinous fluid, and feel soft and moveable. Ganglion cysts have a smooth translucent wall, generally connected to an underlying joint capsule or ligament via a think stalk. Ganglion cysts can involve any joint in the hand or wrist, mainly occur on an aponeurosis or tendon, and are palpable between the extensor tendons. The ganglion cyst forms when tissue around the joint becomes inflamed and swells with fluid. As this happens, the balloon-like ganglion grows in the connective tissue of the joint or even in the membrane that covers the nearby tendon. Often, cysts associated with the scapholunate ligament or scaphotrapezial joint of the wrist. Most cysts occur at the dorsal wrist, volar wrist, and volar retinacular of distal interphalangeal area.
Cause of Wrist Ganglion Cyst
Flaw in the joint capsule. Flaw in the tendon sheath. Tissue trauma.
Signs and symptoms
Swollen sac-like area, which changes size. May or may not produce pain. Wrist weakness.
Complications if left unattended
Most ganglion cyst disappear without treatment, though in some cases, they recur over time. Such cysts generally do not pose a serious health risk, even if left untreated, though pain and weakness of the wrist may persist without medical care.
psGeneralComments Off on Surgical Removal of Ganglions
Surgical treatment may be needed for a ganglion that has not responded to nonsurgical treatment and:
Interferes with activity or motion.
Causes changes in sensation.
Is causing damage to wrist bones, finger bones, or ligaments.
The goal of surgery is to remove the ganglion sac and the connecting tissue that allows the fluid to collect.
Surgical removal of a ganglion is an outpatient procedure.
The area around the ganglion is cleaned with an antiseptic.
A local anaesthetic is injected to numb the area or a regional anaesthetic is injected to numb the whole arm and hand. (General anaesthetic is not usually used because the surgery does not take long and affects only the wrist or hand.)
A cuff (tourniquet), similar to the kind used for taking blood pressure, is placed on the upper arm. This is inflated before the procedure to decrease the blood flow to the hand and wrist.
An incision is made at the ganglion site. The surgeon is careful to protect nerves,tendons, ligaments, and blood vessels while removing the ganglion sac and the connecting tissue.
The incision is closed with stitches, and a bandage and (in some cases) a splint are applied to restrict movement and allow the incision to heal. Some surgeons encourage moving your wrist 3 to 5 days after surgery to prevent stiffness.
Infection and injury to other tissues are rare, but possible, risks of surgery.
Ganglions return in about 5% to 10% of people after surgery. This may happen if the connecting tissue is not completely removed. New ganglions may also form in the area.
In a mucous cyst ganglion, bone spurs (small, bony growths that form along a joint) are often present in the joint next to the cyst, and removing bone spurs makes it less likely that the cyst will return. The chance of infection is higher in mucous cysts.
Call (+65) 6471 2674 (24 Hour) to make an appointment with our orthopaedic surgeon regarding your ganglion today.
psGeneralComments Off on Removal of a Ganglion Cyst
Ganglion cyst is commonly found in the wrist, however, it can grow in the foot as well.
Ways of removing a ganglion cyst
Aspiration of a ganglion cyst (Non-surgical method).
Surgically remove the ganglion cyst.
What is an aspiration of a ganglion cyst?
Aspiration of a ganglion cyst is a conservative method to remove the fluid (aspirate) from the ganglion sac without surgery.
Your doctor can perform the aspiration of the ganglion cyst in the clinic by the following steps:
A local anaesthetic is injected into the ganglion to numb the area.
Once the area is numb, a sterile needle is inserted into the ganglion cyst.
The fluid is drained out of the ganglion sac.
The ganglion collapse like a deflated ballon.
A small plaster is used cover the needle wound.
Aspiration of a ganglion cyst by draining the fluid with a needle may work for some patients but not for all patients. This is because the ganglion sac is still in the body and may gets fill up again, causing the ganglion to reoccur.
Many patients prefers to try the aspiration of the ganglion cyst as the first line of treatment, if the ganglion returns, some opted for surgically remove the ganglion cyst.
Surgical removal of a ganglion cyst
You can consider surgically remove the ganglion cyst if you do not respond well to the conservative way of aspiration of the ganglion cyst or you experience the following:
Obstructing your daily activities or motion.
Changes in sensation.
Damage to the bones or ligaments.
The goal of the surgery is to remove the ganglion sac and the connecting tissue that allows the fluid to collect.
Surgical removal of a ganglion cyst can be done as a day surgery.
Picture of a Ganglion Cyst Removed from the Wrist
Call +65 6471 2674 (24hr) for an appointment to treat your ganglion cyst today.
A wrist ganglion is a swelling that generally occurs over the back of the hand or wrist. These are benign, fluid-filled capsules. Ganglions are not cancerous. Although they may grow in size, they will not spread to other parts of the body.
Symptoms of Ganglion of the Wrist?
The ganglion usually appears as a bump or mass that which appear over time or appear suddenly. It may also get smaller in size and even go away, only to come back at another time.
What are the Causes?
The cause of ganglions is not known. One possible cause is the trauma causing the tissue of the joint or tendon sheath to break down forming small cysts, which then join into a larger, more obvious mass. The most likely cause involves a flaw in the joint capsule or tendon sheath that allows the joint tissue to bulge out.
What are the Treatments?
Many cysts (38-58%) disappear without any treatment at all. Treatments include using a needle to remove the cyst’s contents (aspiration). Surgical removal of the cyst is needed when the mass is painful, interferes with function especially when the dominant hand is involved, or causes numbness or tingling of the hand or fingers.