A ganglion is a benign tumor formation that occurs in the area of an articular capsule. Typically, a fluid-filled cyst forms, which is easily visible and palpable to the outside. Most often, such a joint cyst on the hand or fingers. The elastic nodules often do not cause any discomfort, but they can also be associated with pain or numbness. As a rule, ganglia can be well treated by conservative measures - but sometimes an operation is necessary.
A ganglion is not a high leg
Popularly, a ganglion is often referred to as a suprarenal. This is technically incorrect because it is a bony leg is a bony substance. Colloquially, however, it has become established to speak of a ganglion of a high leg. In fact, a high leg is called an exostosis.
Causes: Why does a ganglion emerge?
A ganglion is one of the soft tissue tumors, with the term tumor merely describing the swelling that occurs through the joint cyst. It is particularly common on the wrists or fingers, and less often on the knees or feet. Ganglia is primarily affected by younger people between the ages of 20 and 30 - women significantly more often than men.
Why exactly one ganglion arises is not yet clear. Presumably both a spontaneous formation as well as a development by chronic irritation conditions is possible. Due to the constant irritation of the tissue, it can happen that more joint fluid is produced.
If the increased production causes a tear in the joint capsule or in the tendon sheath, a cyst can form. This is a cavity filled with fluid, which remains in contact with the joint capsule or the tendon sheath via stilt-like outgrowths.
Symptoms: How to recognize a ganglion
The accumulation of fluid usually causes a visible swelling in a ganglion, which in extreme cases can reach the size of a cherry. Usually a ganglion is a bit smaller. Characteristic is that it occurs in the form of a bulge-filled, elastic nodule.
Often, a ganglion did not cause any discomfort, but it also partially responds to pressure. If the articular cyst exerts pressure on nerves or blood vessels, severe pain or numbness and tingling may occur. Frequently, the pain radiates into the surrounding tissue - for example from the hand to the upper arm.
In small, deep-seated ganglia, only concomitant symptoms can occur without a visible swelling.
Ganglion on the hand and on the fingers
A ganglion is particularly common on the hands or fingers. It can occur on the wrist as well as on the wrist's flexor side. On the fingers, the basic, as well as the middle and end members may be affected.
If a joint cyst forms on the feet, it usually develops on the back of the foot. Occurs on the knee, in particular, the popliteal fossa affected. In rare cases, a ganglion can also form on the shoulder or elbow.
On the wrist, it may happen that the ganglion only becomes visible when you bend the joint. If you can not detect any swelling despite joint pain, you should consult a doctor. Maybe it is then a lower lying ganglion. In addition to the joint pain, a reduced grip strength of the hand can be an indication of a joint cyst.
Diagnose a ganglion
A ganglion can often be diagnosed on the basis of a physical examination. In order to exclude other diseases, such as a tumor, methods such as an X-ray or an ultrasound examination and a magnetic resonance tomography can also be used. These methods are also used when a ganglion is neither visible nor palpable.
Conservative treatment in a ganglion
How exactly a ganglion is treated, often depends on whether or not there are complaints. In the case of little or no complaints, it is usually awaited whether the joint cyst will reform itself. Decreasing ointments and a preservation of the joint can promote the regression of the ganglion.
If the ganglion causes pain or if the mobility of the hand or the foot is restricted, measures such as physiotherapy are initially considered. As a result, for example, the stability of the wrist can be strengthened and the mobility can be improved.
In addition, the following therapeutic measures are possible:
- Needle puncture: The ganglion is punctured and the contained fluid is removed.
- Treatment with cortisone: Cortisone is given to reduce the resulting swelling.
- Treatment with hyaluronidase: The enzymes are injected into the ganglion and degrade the main constituent of the liquid, hyaluronic acid. Subsequently, the liquid is removed by the doctor.
Operative treatment in a ganglion
If the conservative measures are insufficient, the ganglion must be surgically removed. Above all, surgery is necessary if the joint cyst causes so much pain that conservative treatment is out of the question.
To treat the ganglion surgically, one should consult a specialist, a (hand) surgeon. This tries during the operation to remove the entire ganglion. Not only is the fluid-filled cyst removed, but the connection to the joint capsule or tendon sheath is also closed.
In about ten percent of all cases, a ganglion recurs at a later date. However, after surgical removal the risk of relapse is less than with conservative treatment.