Ganglion

In the hand, a ganglion is a particular type of lump which shows up next to a joint or a tendon. Inside, it is like a balloon filled with a thick liquid. It may be soft or hard, may or may not be painful, and may get bigger or smaller on its own. It may also be referred to as a mucous cyst, a mucinous cyst or a synovial cyst.

Normally, joints and tendons are lubricated by a special liquid which is sealed in a small compartment. Sometimes, because of arthritis, an injury, or just for no good reason, a leak occurs from the compartment. Now, the liquid is thick, like honey, and if the hole is small, it can be like having a pinhole in a tube of toothpaste – when you squeeze the tube, even though the hole is small and the toothpaste is thick, it will leak out – and once it is out, there is no way it can go back in on its own. It works almost like a one way valve, and fills up a little balloon next to the area of the leak. When we use our hands for normal activities, our joints squeeze and create a tremendous pressure in the lubricating compartment – this can pump up a balloon leak with so much pressure that it feels as hard as a bone.

The lubricating liquid has special proteins dissolved in it which make it thick and also make it hard for the body to absorb it when it has leaked out. The body tries to absorb the liquid, but may only be able to draw out the water, making it even more thick. Usually, by the time the lump is big enough to see, the liquid has gotten to be as thick as jelly.

What are the treatments for Ganglion?

To seek a orthopaedic surgeon, who will prescribe splint.Drain the cyst with a needle and possibly inject he area with cortisone. This works much better for cysts coming from the tendon than those coming from joints. Perform surgery to remove the cyst and clean out the area where the cyst comes from. Tendon sheath cysts are more likely to be cured with a cortisone shot than cysts coming from joints. Cysts coming from joints are less likely to come back after surgery if the joint itself is “cleaned out”, but cleaning the joint out increases the chance that the joint will be somewhat stiff after surgery. For example, cysts on the back of the wrist come back about one out of three times give the joint is not cleaned out, but only about one out of twenty times if the joint is cleaned out. Cysts on the front of the wrist (volar wrist ganglions) are more likely to come back after surgery than cysts on the back of the wrist (dorsal wrist ganglions).

There are different treatments depending on condition which Dr.Kevin yip will advise during the consultation, if there is a need for a treatment or surgery. For an appointment with Dr.Kevin yip please call +65 6471 2691(24hours).