GANGLION

Ganglion cysts are swellings that most commonly develop along the tendons or joints of wrists or hands. They can be found either at the back or palm side of the wrist, end joint of a finger, or at the base of a finger. A ganglion cyst is not cancerous and will not spread to the other parts of the body. It looks like a water balloon on a stalk and contains a clear fluid or jelly material. Ganglion cysts can be found in people of all ages.

Although the exact cause of a ganglion cyst remains unknown some theories suggest that small cysts are formed when trauma damages the tissue of a joint. The most likely reason might be that these cysts occur because of local degeneration or a defect in the joint capsule or tendon sheath that permits the joint tissue to bulge outwards.

Ganglion cysts generally appear as a mass measuring from 1 to 3 centimetres in diameter. The swelling is usually soft and immobile. It may develop suddenly or gradually over time, vary in size or even disappear or reappear. Ganglion cysts can be painful. If painful, the pain may be continuous and may worsen with the movement of the joint. If the cyst is attached to a tendon, one might feel weak in the affected area.

A ganglion cyst is diagnosed by physical examination. An ultrasound imaging can reveal whether the lump is solid or fluid filled (cystic). It can also determine if an artery or any blood vessel is causing or near the lump.

Magnetic resonance imaging (MRI) of the wrist may also be employed to diagnose ganglion cysts.

In some cases, these cysts may disappear without any treatment. Needle aspiration can be performed to drain the fluid from the cyst using a needle, but have a high chance of recurrence. If the cyst becomes painful or limits your activity, causes numbness or tingling of the hand or fingers, surgery may be recommended to remove the ganglion cyst.

Removal of the ganglion (Ganglion cyst excision) can be done under general or local anaesthesia. It is usually done as an open procedure if it is on the palmar side as the ganglion is often near blood vessels or nerves. Dorsal ganglions may be treated by wrist keyhole surgery.

 

Dr Bala uses special magnification loupes to visualize and protect these structures to minimize complications. In the event you may have a tattoo on the wrist Dr Bala is well versed in suturing tattoos back accurately with absorbable sutures. The ganglion is excised along with its stalk which usually leads to a ligament of the wrist joint. The wrist joint is often washed out (wrist arthrotomy and lavage) in the process to minimize a recurrence.