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Hygroma of the wrist is a benign cystic tumor, which is represented by connective tissue walls. Inside such a tumor contains a liquid. The tumor can form anywhere where there is connective tissue, but most often it forms in the wrist area.
What is a hygroma of the wrist?
Hygroma of the wrist is represented by an outer shell, which consists of connective tissue. It grows from the wrist joint or from synovial bags, which have the appropriate localization. The tumor is divided by the thinnest partitions. Each of its compartments is filled with liquid, which is produced by the walls of the hygroma. The liquid is thick, has a whitish-yellow color.
The hygroma tends to grow. It increases in size due to cell division, which produce large volumes of fluid.
The hygroma does not become malignant over time. It does not spread metastases, therefore it does not pose a threat to human life. To a greater extent, this tumor delivers aesthetic discomfort. Sometimes it can cause pain, as it puts pressure on the tissues and nerve endings that are located in the immediate vicinity of it.
Causes of hygroma of the wrist
Until now, the exact causes that lead to the appearance of hygroma have not been established. However, the main risk factors that can provoke the growth and development of the tumor have been identified.
These include:
Anatomical features of the human hand. Synovial bags of muscles in most people are located in deep structures. They are protected by soft tissues and fat. This keeps them safe from injury. In some people, these bags are close to the surface, so they are often damaged, which can lead to the formation of a hygroma.
Excessive strain on the wrist. If a person, due to professional activity, performs the same type of movements with the wrist joint, this increases the likelihood of injury to the tendons and the joint capsule itself. Therefore, hygroma on the wrist is more often formed in programmers, typists, musicians, builders, loaders, etc.
The presence of tendovaginitis or chronic bursitis. These diseases are accompanied by damage to the tendons and synovial bags. Their tissues become inflamed, more blood flows to them, healthy cells are damaged, and begin to divide more actively. If such a pathological process is present on an ongoing basis, then this increases the likelihood of hygroma formation.
hereditary predisposition. There is evidence that hygromas often appear in blood relatives.
Belonging to the female gender. It has been established that hygromas appear 3 times less often in men.
Treatment of hygroma in the past. This tumor is more likely than other neoplasms to relapse. Even the operation does not guarantee that after a while it will not appear again.
Symptoms of hygroma of the wrist
Most often, hygromas form on the back surface of the wrist joint. The main symptoms of the tumor can be identified as follows:
The tumor appears under the skin. She is clearly visible.
Most often, the tumor is single, although sometimes several hygromas can form at once.
Hygroma of the wrist is mild, but if the disease has a long course, or a lot of fluid accumulates in the cyst cavity, it can become elastic and elastic. Tumors of the type of bone or cartilage on the wrist are rare.
When pressing on the hygroma, a person experiences pain. They can intensify after active load on the limb.
Excessive work of the wrist joint can lead to the fact that the tumor will increase in size. In a state of rest, she again returns to her usual state.
Hygroma has the shape of a regular ball with clear boundaries. It is easy to displace relative to the skin.
The dermis above the tumor is not changed, it has a flesh color, but with strong tension it can peel off and become thinner. If the skin turns red, then this will indicate inflammation of the hygroma, which can be aseptic or purulent.
The average diameter of the wrist hygroma is 3 cm, although sometimes the tumor can reach 6 cm or even more.
Depending on the exact location of the hygroma, some of its features are distinguished.
If the tumor has formed on the back of the wrist, then it will have the following characteristics:
The average size of the hygroma is 5 cm, its height is 2 cm.
If the tumor grows from the joint, then it is not very mobile. When the hygroma grows from the synovial bag, it moves along with the vagina.
A hygroma on the back of the wrist can put pressure on the terminal section of the radial artery that runs through this area. Its compression is manifested by pain in the thumb, which intensifies after the load on it.
Sometimes a hygroma growing on the back can lead to compression of the nerve endings, which will be manifested by a violation of the sensitivity of the thumb, index and / or middle finger (with damage to the radial nerve). If the sensitivity of the little finger or ring finger is affected, this indicates that the tumor is pressing on the ulnar nerve.
When a hygroma forms on the palmar side of the wrist, it has the following characteristics:
The average tumor size is 2 cm in diameter.
Hygroma, which grows from the synovial sheath of the thumb, has maximum mobility.
If the tumor begins to press on the arteries, then this is manifested by weakness and pain in the hand, which intensifies when it is bent.
Although multiple symptoms of hygroma have been described in the section, they rarely manifest themselves in full. Most patients do indicate that the tumor does not cause them any inconvenience, except for minor discomfort after a bruise or with intense movements of the limb.
What is dangerous hygroma of the wrist?
Many people with hygroma are of the opinion that there is no need to remove the tumor, since it is not capable of rebirth. In fact, you need to get rid of the neoplasm. The fact is that, like any other cysts, hygroma tends to grow. There are many nerve fibers and blood vessels in the wrist area.
As it increases in size, the hygroma will begin to put pressure on them, which will lead to such violations as:
Decreased sensation in the hand and fingers.
Paresthesia and paresis of the hand.
Pain in the corresponding area. The pain will resemble backache.
Deterioration of the nutrition of the hand against the background of compression of blood vessels. In this case, the skin of the hand will suffer, nails may crumble, muscles will become weak. In severe cases, small ulcers and pustules may appear.
If the veins are clamped, then this threatens with edema.
Therefore, if a hygroma is detected, you need to seek the advice of a doctor and remove the tumor in a timely manner. Another reason to get rid of the neoplasm is a cosmetic defect.
Diagnostics
Diagnosis of hygroma begins with its examination, palpation and listening to the patient’s complaints.
To make sure that the tumor is benign and distinguish it from other neoplasms, a person can be referred to such instrumental examination methods as:
X-ray of the hand. This technique allows you to distinguish hygroma from osteosarcoma and other pathologies of bone tissue.
Ultrasound. This method is the most accessible and informative in terms of diagnosing hygroma. Ultrasound allows you to assess the size of the tumor, provides information about its structure and connection with surrounding tissues.
If the doctor has doubts about the benignness of the tumor, then he can refer the patient to an MRI, as well as to a puncture. However, such studies with hygroma are rarely prescribed.
Treatment
Modern ideas about the treatment of hygroma boil down to the fact that it must be removed surgically. Other treatments are ineffective.
The operation is necessary for the following reasons:
The tumor will grow in size if it is not removed. Surgery is the only reliable way to prevent complications of hygroma.
Fast recovery period. If a person turned to a doctor at an early stage of hygroma formation, then the volume of the operation will be insignificant. Within a few days, the patient will be able to return to their usual way of life.
Reducing the risk of disease recurrence. During the operation, the doctor has the opportunity to remove all elements of the tumor. It cannot be done in any other way.
Improving the appearance of the wrist. Hygroma, located on the wrist, will be in plain sight. If removed, the scar remains unnoticeable.
The operation is most often carried out in the standard way, that is, the hygroma is excised with a scalpel. Although, if desired, a person can choose a laser technique for removing the tumor. However, most experts point out that it is better to opt for the classical technique.
Operation execution algorithm:
The patient is given a local anesthetic. As a rule, general anesthesia for hygroma is used only in severe cases, when the tumor reaches an impressive size.
The skin, which is located above the hygroma, is treated with an antiseptic solution.
The tissues surrounding the neoplasm are dissected in layers to expose it.
Particular attention should be paid to the base of the tumor. If small cysts are found in the surrounding tissues, then they must also be removed.
The hygroma is not opened, it is removed entirely.
The wound is sutured, covering it with a sterile bandage from above. The brush is fixed with a plaster splint. Immobilization is performed in the case when the hygroma of the wrist is large.
The procedure takes about half an hour. During this period, the patient will not experience pain. During rehabilitation, discomfort may occur. They are treated with painkillers. The bandage must be changed every day. After 5-7 days, you can refuse to wear it.
Is it possible to get rid of hygroma in conservative ways?
In the medical literature of past years, one can find information about the fact that hygromas are treated using conservative techniques. For example, with the use of physiotherapy methods (UVI, UHF, magnetotherapy, etc.), with the use of puncture or by introducing antibiotics, sclerosing drugs, etc. into the cyst. As practice has shown, these procedures are not effective. After some time, the hygroma grows again. After conservative therapy, the hygroma recurs in 80-90% of cases.
The matter is that the tumor is penetrated by capillaries. There are not many of these vessels, but enough to support the vital activity of neoplasm cells. Their incomplete removal will lead to the fact that the tumor will grow again. In addition, warming up and other physiotherapeutic techniques contribute to the fact that the tissues of the hygroma will receive enhanced nutrition, and it will begin to grow faster. Therefore, the only way to get rid of it is an operation. Although in some cases, even after its implementation, the tumor recurs. The risk is 8-20%.
[Video] Doctor Egorov – hygroma of the hand. Get rid easily!