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GANGLION


What is a ganglion?

Ganglia are the most common masses seen in the hand. The word ganglion is derived from the Greek word for "knot". Ganglia are cyst-like (balloon) structures that are filled with gel-like mucinous fluid that is very similar to joint fluid. This is also the clue that these structures originate from a joint. The joints are rather predictable, and when the ganglion arises from the back of the hand, it is most commonly arising from the scapholunate joint.

When the ganglion arises from the front or palm side of the hand, it is either coming from the wrist (radio-scaphoid joint) or the STT joint (scapho-trapezio-trapezoid joint) or the radio-ulnar joint. The cyst has a thick membrane that becomes adherent to the surrounding tissue and a thick stalk that is anchored all the way down in the joint. There is a grape-like protrusion found at the base of this stalk on the joint capsule or ligaments that might be part of the development of this mysterious structure. The joints, from which the ganglion arise, are generally normal. We know that there is a one-way valve system that allows joint fluid from the joint into the stalk but not the other way around. The activity of the wrist creates a normal circulation of the joint fluid but also acts as a pump that ejects fluid into the ganglion.

What are the related symptoms of a ganglion?

The most common signs and symptoms of a ganglion cyst include a visible hand bump, discomfort and pain. If the ganglion cyst is located near a nerve, it may cause loss of mobility, numbness, pain and a tingling sensation. In some cases, ganglion cysts may become bigger or smaller over time.

How are ganglion cysts treated?

The controversial treatment of this peculiar disease was to hit the ganglion with a big Bible with the intention to burst the balloon. This brought temporary relief with high rates of recurrence. A ganglion cyst can be aspirated with or without steroid injections. It has not been shown to reduce recurrence rates by injecting anything into it. These aspirations and injections still carry a recurrence rate of about 60%.

For patients with symptomatic and painful ganglion cyst, surgical excision is a reasonable method of treatment. Ganglion wrist surgery can be done open or arthroscopically through the wrist joint. The aim is to excise the ganglion and carefully dissect it free from all the surrounding tissue, but more importantly, to dissect the stalk down to the level of the joint to prevent a recurrence. Ganglion wrist surgery outcome is generally good, with recurrence rates of less than 5%.

icon-5

GANGLIONS


What is a ganglion?

Ganglia are the most common masses seen in the hand. The word ganglion is derived from the Greek word for "knot". Ganglia are cyst-like (balloon) structures that are filled with gel-like mucinous fluid that is very similar to joint fluid. This is also the clue that these structures originate from a joint. The joints are rather predictable, and when the ganglion arises from the back of the hand, it is most commonly arising from the scapholunate joint.

When the ganglion arises from the front or palm side of the hand, it is either coming from the wrist (radio-scaphoid joint) or the STT joint (scapho-trapezio-trapezoid joint) or the radio-ulnar joint. The cyst has a thick membrane that becomes adherent to the surrounding tissue and a thick stalk that is anchored all the way down in the joint. There is a grape-like protrusion found at the base of this stalk on the joint capsule or ligaments that might be part of the development of this mysterious structure. The joints, from which the ganglion arise, are generally normal. We know that there is a one-way valve system that allows joint fluid from the joint into the stalk but not the other way around. The activity of the wrist creates a normal circulation of the joint fluid but also acts as a pump that ejects fluid into the ganglion

.

What are the related symptoms of a ganglion?

The most common signs and symptoms of a ganglion cyst include a visible hand bump, discomfort and pain. If the ganglion cyst is located near a nerve, it may cause loss of mobility, numbness, pain and a tingling sensation. In some cases, ganglion cysts may become bigger or smaller over time.

How are ganglion cysts treated?

The controversial treatment of this peculiar disease was to hit the ganglion with a big Bible with the intention to burst the balloon. This brought temporary relief with high rates of recurrence. A ganglion cyst can be aspirated with or without steroid injections. It has not been shown to reduce recurrence rates by injecting anything into it. These aspirations and injections still carry a recurrence rate of about 60%.

For patients with symptomatic and painful ganglion cyst, surgical excision is a reasonable method of treatment. Ganglion wrist surgery can be done open or arthroscopically through the wrist joint. The aim is to excise the ganglion and carefully dissect it free from all the surrounding tissue, but more importantly, to dissect the stalk down to the level of the joint to prevent a recurrence. Ganglion wrist surgery outcome is generally good, with recurrence rates of less than 5%.


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