Ganglion cysts are usually seen in the dorsal part of the wrist, and sometimes can also be seen in the inner part of the wrist or in the articulation area of the thumb and other fingers, or at the bases of the fingers. They are painless swelling with medium stiffness. They are harmless cysts, which disappear spontaneously in the course of time.
Ganglion appears in the form of swelling that originates from the connective tissue between the bone and the muscle tissues located in the joint. This swelling contains a viscous and lubricious material with properties similar to that of the synovial fluid. As a general rule, the swelling gets enlarged with an increase and subsides with a decrease in your physical activities.
What are the causes the disease ?
The causes initiating the formation mechanism of ganglion is still unknown. It is more common in women, compared to men. It is more commonly seen in young women, those who use keyboard, who crochet, and who do gymnastics.
What are the Symptoms and Findings of the Disease ?
They may become painful by creating compression on the adjacent tissues such as nerves and tendons because they are space-occupying masses. It is interesting that big ganglions are usually painless, whereas small ganglions, also called hidden ganglions, can become painful by settling in the joint space of the wrist. It can shrink and grow, and can be in a variety of sizes from a size of a green lentil and chickpea to greater sizes. It tends to be large in an active hand, and can shrink with rest.
In diagnosis, the physician performs palpation of the area. The transparency is evaluated with a light source. For a definitive diagnosis, an X-ray is taken to exclude the possibility of any bone tumors. An x-rays to be taken and tests to be performed will be used to investigate whether the case has been caused by a bone tumor or a joint disorder induced by a rheumatic diseases.
What are the Treatment Options for the Disease ?
The first stage of the treatment consists of conservative procedures. Since ganglion is not a tumorous structure, and can spontaneously disappear in the course of time, the patient can wait for a certain period of time, as long as he/she keeps it under control. Since the size of the ganglia would increase with activity, and since that increase would lead to a pain due to nerve compression, it is recommended to follow up the wrist while it is fixed in a fixation brace or plaster. In the meantime, the ganglion may shrink or even disappear. After the reduction of the pain and shrinkage of the ganglion, a treatment intended for increasing the range of motion of the wrist is started.
Aspiration: In cases where ganglion causes pain or grows to an extent that creates a limitation of motion, the liquid in the ganglion can be taken out by means of a process called “aspiration”. But in this process, the attempt to discharge the liquid may result in failure due to its high-viscosity.
If the limitation of motion and pain caused by the ganglion cannot be eliminated with the treatment procedures described above, the ganglion is required to be surgically removed. However, the point to note is that the ganglion is likely to recur after this process. After this process, problems such as pain and swelling may be encountered for a period of few days.