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A gelatinous cyst (ganglion) is a spherical tumor that is not cancerous. The cyst connects to the tendon sheath or to the articular cavity, it contains gelatinous, slightly yellow content. It occurs on the back of the hand, around the wrist, less often on the back of the foot. Smaller cysts are punctured with a needle and their contents are sucked out, while larger cysts require surgical treatment.
What is a gelatinous cyst?
A gelatinous cyst (gangilon) is a benign subcutaneous nodule inside which there is a gelatinous (transparent) substance or a yellow liquid. This lesion is usually located on the dorsal or palmar part of the wrist or around the lunate bone. In short – it is formed in the area of joint capsules and tendons. Sometimes it can occur in the foot area. The gelatinous cyst is much more common in women than in men, between the ages of 20 and 40. What is the mechanism of cyst formation? Well, the wrist joints are filled with a liquid substance that gives them mobility. When this fluid is excessively produced, a fragment of the skin of the wrist is bulged in the form of a lump. Ganglions are typically 0,5 cm to 2 cm in diameter.
What are the causes of a gelatinous cyst?
Cysts can form as a result of recurrent injuries, overloads, inflammations and increased work of the tendons. Then the tendon sheath begins to produce an excessive amount of synovial fluid to protect the tendons. The consequence of this is the formation of a bulge and thickening of the sheath, i.e. the formation of a gelatinous cyst. Also, overloading the joints, their injuries and excessive movement lead to this ailment.
Gelatinous cyst – symptoms
A gelatinous cyst is a hard and sliding lump visible on the wrist that is accompanied by:
- sensitivity during palpation of the lesion,
- numbness at the site of the lump
- sensory disturbances,
- pain when loading the joint with a gelatinous cyst,
- inflammation in the area of the cyst, especially after straining the joint,
- limited hand mobility,
- sometimes muscle paresis (due to the pressure of the cyst on small nerves located in the dorsal area of the wrist).
Symptoms of a gelatinous cyst usually resolve with rest. Sometimes gangilone is absorbed by itself, but you should see a doctor when the lesion is not getting better and symptoms persist. You may need to remove the cyst.
Diagnosis of a gelatinous cyst
A gelatinous cyst is diagnosed based on the symptoms present. Sometimes, however, doctors have doubts, and then they order an auxiliary ultrasound, hand X-ray or magnetic resonance imaging. These methods help to differentiate gangilon from other ailments, e.g.
- arthritis,
- necrosis of the scaphoid bone,
- neuroma,
- malignant tumor,
- wrist bone fracture.
In addition, imaging tests are useful in determining the size and type of the lesion.
Gelatinous cyst – treatment
1. Non-surgical methods of treating a gelatinous cyst
In the initial stage of the disease, an attempt is made to treat the joint by stabilizing the joint with an orthosis or plaster. As a result, the movement in the joint is significantly reduced, and the inflammation is also treated. If such actions do not bring the expected benefits, the cyst is punctured with a syringe and its contents are aspirated. Then, a corticosteroid preparation is administered to the puncture site to accelerate tissue scarring. This type of method requires the patient to rest after the procedure and place the hand in the orthosis so as not to overload the joint.
Attention! Administration of corticosteroids may have some side effects in the form of atrophy of the subcutaneous tissue, manifested by a whitish shade of the skin and depression of the tissues.
2. Surgical methods of treatment
They are undertaken when the actions taken so far have not brought any effect. During the procedure, the doctor cuts a small tissue incision just above the gelatinous cyst, and then cuts the lesion together with a fragment of the affected tendon sheath or joint capsule. After the operation, the patient should have the limb immobilized for about a week.
3. Rehabilitation
Physiotherapy treatments are helpful both during the formation of the cyst and after its excision. With minor changes, the use of laser therapy and ultrasound helps to absorb the cyst. In addition, the use of “tepa” patches, after putting on which restricts the mobility of the joints, which in turn accelerates tissue regeneration and helps to minimize lesions.
However, after the surgery, doctors recommend gentle tissue massage and cryotherapy treatments. After the joints are scarred, exercises are carried out to strengthen them. It should be remembered that both surgical and non-operative methods do not guarantee that the gelatinous cyst will not return in the past.
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