Ganglion

A ganglion is a small, usually hard bump above a tendon or in the capsule that encloses a joint. A ganglion is also called a synovial hernia or synovial cyst.

Description

A ganglion is a non-cancerous cyst filled with a thick, jelly-like fluid. Ganglions can develop on or beneath the surface of the skin and usually occur between the ages of 20 and 40.

Most ganglions develop on the hand or wrist. This condition is common in people who bowl or who play handball, raquetball, squash, or tennis. Runners and athletes who jump, ski, or play contact sports often develop foot ganglions.

Causes and symptoms

Mild sprains or other repeated injuries can irritate and tear the thin membrane covering a tendon, causing fluid to leak into a sac that swells and forms a ganglion.

Ganglions are usually painless, but range of motion may be impaired. Flexing or bending the affected area can cause discomfort, as can continuing to perform the activity that caused the condition.

Cysts on the surface of the skin usually develop slowly but may result from injury or severe strain. An internal

A ganglion is a non-cancerous cyst filled with a thick, jelly-like fluid. Ganglions can develop on or beneath the surface of the skin, most likely on the hand or wrist, although runners and skiers often develop them on the foot. (Illustration by Electronic Illustrators Group.)

ganglion can cause soreness or a dull, aching sensation, but the mass cannot always be felt. Symptoms sometimes become evident only when the cyst causes pressure on a nerve or outgrows the membrane surrounding it.

Diagnosis

Diagnosis is usually made through physical examination as well as such imaging studies as x ray, ultrasound, and magnetic resonance imaging (MRI). Fluid may be withdrawn from the cyst and evaluated.

Treatment

Some ganglions disappear without treatment, and some reappear despite treatment.

Acetaminophen (Tylenol) or other over-the-counter analgesics can be used to control mild pain. Steroids or local anesthetics may be injected into cysts that cause severe pain or other troublesome symptoms. Surgery performed in a hospital operating room or an outpatient facility, is the only treatment guaranteed to remove a ganglion. The condition can recur if the entire cyst is not removed.

A doctor should be notified if the surgical site drains, bleeds, or becomes

• inflamed
• painful
• swollen or if the patient feels ill or develops:
• head or muscle aches
• dizziness
• fever following surgery

The patient may bathe or shower as usual, but should keep the surgical site dry and covered with a bandage for two or three days after the operation. Patients may resume normal activities as soon as they feel comfortable doing so.

Prognosis

Possible complications include excessive post-operative bleeding and infection of the surgical site. Calcification, or hardening, of the ganglion is rare.

Prevention

Exercises that increase muscle strength and flexibility can prevent ganglions. Warming and cooling down before and after workouts may also decrease the rate of developing ganglions.