Ganglion Cysts

A ganglion cyst is a tumor or swelling on top of a joint or the covering of a tendon. It is a fluid filled sac which can be felt below the skin. The cause of these cysts is unknown although they may form in the presence of joint or tendon irritation or mechanical changes. It is also known as a wrist cyst, Bible cyst, or dorsal tendon cyst. It is usually attached to a tendon sheath in the hand or wrist or connected with an underlying joint;  however, some have no obvious connection to any structures. It may be soft or hard, may or may not be painful, and may get bigger or smaller on its own. It looks like a sac of liquid (cyst). Inside the cyst is a thick, sticky, clear, colorless, jellylike material. Most commonly, ganglions are seen on the wrist (usually the back side) and fingers, but they can also develop around joints on the shoulder, elbow, knee, hip, ankle and foot. The ganglion cyst often resembles a water balloon on a stalk (see Figure 2), and is filled with clear fluid or gel.

Ganglia can form around any joint but they are most frequently found in the wrist and ankles.Ganglion cysts may be single or multilobulated. They are smooth-walled, translucent, and white. They can increase in size when the tissue is irritated and often can "disappear" spontaneously. These masses or cysts appear to grow sometimes but they are not tumours or cancerous. Ganglion cysts, also known as Bible cysts, are more common in women, and 70% occur in people between the ages of 20-40. Ganglion cysts are generally asymptomatic or minimally symptomatic. Symptoms such as limitation of motion, pain, paresthesias, and weakness are possible. In most cases, ganglion cysts cause no pain and require no treatment. In many cases, ganglion cysts go away on their own. One common type of ganglion, called a mucous cyst, occurs with osteoarthritis of the hands. This type of ganglion is usually found at the joint nearest the fingernail.

Causes of Ganglion cysts

The common causes and risk factor's of Ganglion cysts include the following:

• The exact cause of the formation of ganglion cysts is still unknown.
• A herniation of the synovial lining of joints and tendon sheaths.
• A ganglion develops when a jelly-like substance accumulates in one of two places - a joint capsule or a tendon sheath - and causes it to balloon out.
• Some type of injury.
• A ganglion cyst might develop after something drops on the foot, if the foot was twisted while walking, or after too much stress was placed on a joint or tendon.
• Regular, repetitive movement that stresses your wrist or hand.

Symptoms of Ganglion cysts

Some sign and symptoms related to Ganglion cysts are as follows:

• The ganglion cyst usually appears as a bump (mass) that changes size.
• The lump is usually soft and immobile.
• In some cases, the lump is painful and aching, particularly those at the base of fingers.
• Ganglion cysts on the finger may produce deformities of the fingernail. 
• Pain or tenderness at the site of the bump.
• When the cyst is connected to a tendon, you may feel a sense of weakness in the affected finger.
• The back of the hands and wrists are most commonly affected.

Treatment of Ganglion cysts

Here is list of the methods for treating Ganglion cysts:

• Aspiration usually includes placing a needle into the cyst, drawing the liquid material out, injecting a steroid compound, and then splinting your wrist to keep it from moving.
• A steroid solution is injected into the cyst. This is usually done just after aspiration.
• If a ganglion cyst tends to reoccur, surgical removal may be recommended.
• Acetaminophen (Tylenol) or other over-the-counter analgesics can be used to control mild pain.
• Wearing shoes that do not rub the cyst or cause irritation may be advised. In addition, placing a pad inside the shoe may help reduce pressure against the cyst.
• A brace or splint may be recommended to immobilize the wrist and reduce swelling.

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