A Ganglion is a benign tumor (non-cancerous growth). Its name is arrived from the Greek word ‘knot’ which describes its general appearance. It is filled with a jellylike substance (usually with a bluish tinge), and many feel soft or hard when pressed.
Ganglia are usually firm smooth lumps or (cysts) just under the surface of the skin. Most are about the size of a pea, but some grow much larger.
Ganglia most commonly develop on the back of the wrist, although they are usually found around the ankle joint or the fingers. They are most likely to occur in children and young adults.
What cause Ganglion?
Although some doctors believe Ganglia may be caused by repetitive minor injuries, their underlying cause remains unknown. Whatever triggers the swelling, it usually arises either in the joint capsule (the lining of a joint) or in a tendon sheath (the tough material surrounding some tendons, which themselves attach muscle to bone).
A Ganglion may extent to the wrist or other side by means of a connecting stalk.
Often Ganglia will resolve (disappear) on their own over a period of several months. However, because Ganglia tend to occur in clusters, sometimes a new cyst will arise at the same site, while a small proportion will recur even after surgical removal (a procedure that is known as Ganglionectomy).
How is a Gang diagnosed and treated?
Doctors can usually make a diagnosis based on the characteristic site and appearance of the cyst and by palpating (feeling) it. If there is any doubt as to the diagnosis, a small amount of the liquid content of the ganglion may be removed using a technique known as aspiration.
In this process, a needle is inserted into the swelling, and some of the fluid is withdrawn into the syringe. The fluid sample may then undergo laboratory analysis to ensure that the growth is benign.
If the ganglion does not cause pain, and is not large enough to cause any sort of serious disfigurement, or obstruction to the function of the tendon or joint involved, further treatment is usually considered unnecessary.
However, in severe cases, ganglionectomy may be recommended. This is a procedure carried out by an orthopaedic surgeon (a doctor who specializes in disorders of the bones and joints). Ganglionectomy may either be performed in hospital under general anaesthetic; or as an outpatient procedure in the in the specialists clinic, using a local anaesthetic.
After surgery to remove the cyst, the surrounding area may be swell significantly. It may be necessary to wear a splint for 7-10 days, and the wrist (or ankle, if there is where the ganglion occurred) should be rested during this time. Stitches will be removed after another week or so, but patients are instructed not to use the affected area in a forceful manner for a further week or two.
Ganglia that originate in the wrist joint may be very difficult to remove completely and therefore have a greater tendency to recur after surgery.
When should I see my doctor?
Never assume that any lump is a harmless ganglion. Always see your doctor if any unexplained growth, swelling, or lump appears on any part of the body, I order to rule out the possibility of cancer.
What will the doctor do?
If the Ganglion is causing any pain, or if it is large enough to cause cosmetic disfigurement, several options are available.
As an initial measure, the doctor may try to burst the ganglion by applying firm pressure to it. Or using needle aspiration, the doctor may simply withdraw as much of the fluid contents as possible, which may make the ganglion disappear, or at least reduce its size.
After needle aspiration, some doctors also inject a steroid drug into the area, which may help prevent recurrence. Others inject an irritating (sclerosing) solution into the cyst In order to create scar tissue inside it and, in effect, seal the cyst off, preventing the accumulation or more jelly-like liquid.
However, this approach poses a risk of irritating the lining of the joint or tendon, which could possibly lead to impairment of its range of motion.
Finally you may be referred to as specialist.
What can I do myself?
There is no recommended self-treatment for a ganglion. In the past there was a practice of hitting them forcefully with a heavy object. The blow will rupture the ganglion, and its jelly-like substance would eventually reabsorbed into the surrounding tissues. However, this should not be attempted due to the risk of damaging the area.
How can a ganglion be avoided?
While there is nothing you can do personally do to avoid a ganglion, sometimes recurrence can be prevented by injection of a corticosteroid drug into the area after a ganglion has been
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