A ganglion cyst: wrist, hands, feet — treatment, causes
A ganglion cyst is a benign tumor formation, located near the joint. It is usually found on the hands and feet, the wrist, rarely in other parts of the body. The ganglion cyst is very common among young people. in children and the elderly, on the contrary, the hygroma is happy rare.
With regard to the gender of patients, the statistics diverge. Some researchers indicate that the ganglion cyst usually appears in women, others insist on the predominantly «male» spreading of the cyst. Both viewpoints can be justified: women are prone to hygromas due to weaker ligaments and a heavy load when carrying children in their arms, men in principle have a strong load during the whole life, lifting weights, playing sports, choosing a physically demanding profession.
Favorite localization of cyst think the wrist joint, it is up to half of cases of all benign tumors. In this region the ganglion cyst becomes noticeable even at small sizes, gives aesthetic discomfort, may cause pain due to the close location of the nerve trunks.
Not presenting a danger to life and leaking benign, it may take a long time to be seen if, without proper treatment, which leads to an increase of its size, the appearance of pain, visible to the naked eye rounded education.
It is recognized that the only correct tactics at the hygroma is surgical treatment, since other ways of dealing with education have a high risk of recurrence. Perhaps the development of inflammation in the injury or crushing of the cyst.
Causes and mechanism of formation of hygroma
Causes of gigram not been fully elucidated, but a large role:
- Inflammatory processes in the elements of the joint;
- Hereditary predisposition, when a pseudotumor and is seen in close blood relatives;
- Prolonged stress on the joint.
These factors may contribute to the ganglion cyst alone or in combination, which is quite common. For example, chronic inflammation with trauma or ligament damage with subsequent reactive inflammation.
Trauma is the most common cause of synovial cyst (approximately one third of cases), and repeated injuries to a greater extent contribute to the development of this psevdoopujol. With prolonged stress on the joint associated with the appearance of gigram people in certain professions – a ganglion cyst of the hand in pianists, seamstresses, cooks.
Inflammation of the elements of the joint – bursitis, tendonitis, tenosynovitis, can cause an excessive production of synovial fluid, protrusion of membranes and the formation of Wagram. Usually it happens in subacute inflammation with a gradual accumulation of excess fluid.
It is noticed that the synovial cyst can occur in women after childbirth, which is associated with excess strain on your wrist when wearing the baby in her arms. A ganglion cyst of the foot provoked not only by the injuries which is very likely in this part of the body, but uncomfortable and poorly matched in size shoes.
Anatomically the ganglion cyst is a round, bad move education near the joints located under intact skin. Consistency may be soft or dense, like bone, which depends on the location of education. Hygroma are in close connection with the elements of the joints, tendon sheaths. Their walls are formed by connective tissue, and inside is colorless or yellowish jelly-like contents.
Manifestations of Wagram
Hygroma in the early stages does not bother the patient’s pain, but manifests itself in the form of the visible eye circular formation around the joint. Often she is single, although there are cases when cysts formed several. Pseudotumor soft or dense, always with clear boundaries, are located subcutaneously.
A ganglion cyst is associated with the elements of the joint, so attempts to move it failed, but the skin and surrounding tissue is shifted to the right, which indicates the purity of the tumor. A ganglion cyst is usually not accompanied by changes in the skin, but when sufficiently large amounts may cause its thickening, flaking, and redness.
Small cysts not compressing the neuro-vascular bundles alone does not bring the patient pain. The pain may appear when you try to push or test the formation, during movement of the joint. After exercise, the patient may note a slight increase in the size of hygroma, but after some time the cyst comes back to its original state.
For large hygroma in addition to pain, may experience numbness due to compression of the nerves, and obstruction to outflow of blood in the veins is caused its stagnation. You can restrict the mobility of joints, change in gait, lameness.
Synovial cyst grows slowly for many years it remained the same size, which usually do not exceed 2-3 cm. Sometimes there is rapid growth, which is associated with inflammation, repeated injury or excessive stress on the joint.
Due to the presence of dense connective capsule, independently opened and emptied hygroma is not capable. This can occur when a mechanical impact or surgical manipulation. Output the contents of cystic cavity threat hit it in the joint tissues and inflammation. Healing occurs gradually, with the shell of the cyst recover and begin to secrete fluid. This may result in the appearance of multiple cysts instead of one damaged.
The ganglion cyst has signs of malignancy, therefore, never becomes a cancer. Attention to it due to the more cosmetic considerations and pain caused to the patient during movement or at rest.
A ganglion cyst of the wrist is usually formed on the back side and is clearly visible under the skin. If it is under bond and has a small size, you can see it is possible if a strong flexion in the wrist joint. Nadzwyczajny hygroma appears under the skin as round, clearly demarcated and lack of education, most often painless, but movement can cause pain. The most common complaint of patients with ganglion cyst of the wrist, aesthetic discomfort.
A ganglion cyst finger is placed in the area of distal phalanx or small joints. It is dense, rounded, not painful, the skin over the cyst stretched and thinned. If the cyst is formed on the palm side, it is characterized by larger sizes, can cover the whole and even just two finger.
A distinctive feature of gigram the Palmar surface of the hands believe severe pain. This is due to the abundance of nerves that passes on the inner and lateral surfaces of the fingers. Painful ganglion cyst base of finger, but the sizes are often small.
On the foot a ganglion cyst is most often located in the rear of the foot and toes. The main reason it is considered the injury which the legs are very exposed. Synovial cysts in the feet do not cause inconvenience in the form of pain, but with repeated damage, the compression of the shoes possible the pain and inflammation as cysts, and structures of the joint.
In addition to the foot a ganglion cyst can be detected in the knee joint. This is caused by the high rate of injury to the knee, especially in athletes and people leading an active lifestyle. Play a role arthritis and arthrosis. Hygroma of the knee may long remain invisible to the eye, being located in the region of the popliteal fossa, on the posterior surface of the leg. However, this location prevents the full flexion of the limb, causes pain and requires urgent surgical treatment.
The term hygroma can be called cysts of the neck, detectable in newborns. In fact, these cysts are ganglion cyst, but a developmental disorder of the lymphatic apparatus.
Diagnosis and treatment of hygroma
Diagnosis hygroma usually is not much difficulty, and after inspection the doctor is clear with what he has to deal with. Palpation of education and conversation with the patient immediately suspected a ganglion cyst, and for specification of the diagnosis can be attracted by additional methods:
- X-rays of the joint;
- Ultrasound examination;
- The puncture of the cyst contents;
These diagnostic procedures give an opportunity not only to clarify the nature of the tumor, but also to determine the characteristics of blood supply, type of content, connection with surrounding tissues, condition of the articular elements.
Until recently was widely used conservative methods of removal hygroma. This is understandable, because most patients prefer treatment without surgery for fear of complications, need for anesthesia and physical discomfort. Hygroma kneaded, crushed, punctured, deleting content, and inserting into the cavity of the education sklerosiruuschem substances. There were attempts to use physiotherapy, mud treatments, medicines of local action.
Practice has shown that to get rid of hygroma conservative methods almost impossible. Of course, after the procedure it may be reduced or even totally disappear, but after a while will appear again. The recurrence rate with conservative treatment reaches 90%, so this method is neither effective nor appropriate. Moreover, the crushing or kneading can lead to violation of the integrity of the membranes of the cyst, the outpouring of content in the tissue with consequent inflammation, the appearance of several small instead of one large gigram, then tactics, and the prognosis will be much more serious than the surgical removal.
Bezoperatsionnye methods with the abandonment of the elements of the capsule hygroma within the joint does not lead to a cure, since the membranes of cysts continue to form the liquid. Pseudotumor does not pass and continues to grow. Resorting to puncturing, the patient can undergo the procedure multiple times without the desired effect, so conservative treatment, at best, give a temporary effect, at worst a lot of complications.
Some clinics now offer non-surgical removal of Wagram, but experts still inclined to think that surgery is the only way to get rid of the tumor. Of course, there are relapses after the operation, but the frequency does not exceed 20%.
Deletion of hygroma is usually performed in trauma or surgical ward. Testimony to it I think:
- The presence of pain at movement or at rest;
- Violation of mobility in the joint;
- Aesthetic defect;
- The rapid increase in the cyst.
Situated on the hands or feet, the ganglion cyst interferes with the normal movement in small joints, causing pain, so it’s best to remove it. Aesthetic discomfort may experience the patients with small tumors that do not cause pain or limitation, but it will be an indication for excision of the cyst. Special attention should be paid to the rapidly growing hygroma as they compress the neurovascular bundles, the elements of the ligamentous apparatus of the joint, and, therefore, removing them would involve greater difficulties than small entities.
Surgical treatment is recommended in a hospital environment. This is due to the possible opening of the joint cavity or tendon bags, which may require additional manipulation and dangerous complications of improper surgical technique.
When you remove hygroma enough local anesthesia, while the patient is awake but feels no pain. If the tumor is large, adjacent to the nervous and vascular trunks, has a complex arrangement, surgeons resort to regional anesthesia or even General anesthesia.
For a clearer separation of the cyst from the surrounding tissue superimposed tourniquet above her location. Bleeding and anesthesia allow the doctor to better determine the exact size of tumors and the surrounding tissues.
After dissection of the skin and subcutaneous layer, the ganglion cyst is released, inspected, especially in the area of the base, and then excised. When detected in the adjacent tissues other small cysts, the doctor removes them. It is very important to observe the principle of radicalism, leaving even tiny fragments of the shell of the cyst, which could be a source of relapse.
After removal of hygroma, the cavity was washed and the tissue is sutured, leaving in the wound rubber drainage, which is then removed after 1-2 days. The operation lasts about 30 minutes depending on the complexity of manipulation and configuration hygroma. After the operation, shows the imposition of a pressure bandage or a plaster splint for large periarticular cysts or hygroma brush. With proper healing and remove the sutures in about a week.
In addition to the complete removal of the cystic cavity and its membranes, some surgeons are practicing flashing feet of the formation without removal of the entire hygroma. In case of damage of the ligamentous elements of education operation is complemented by the plasticity of the ligament.
The development of endoscopic techniques allows the use of it in this area of medicine. Endoscopic removal of hygroma reduces surgical trauma, leaves a small scar and is accompanied by a more rapid recovery.
In some clinics practiced removal hygroma laser. In this case, the cyst prikalivatsja, it retrieves content, and then enter the light guide. Laser radiation acting on the shell hygroma, causing their destruction, as though it seals the small blood vessels, reducing the possibility of bleeding.
Such manipulation has the advantages as it does not require a large incision speeds up healing and tissue around tumors are not damaged. In addition, the laser gives a good cosmetic result. After laser treatment is assigned to wearing the splint for about a week and limiting physical exertion to the affected area to reduce the likelihood of recurrence.
We should also mention the treatment folk remedies, the interest which continues unabated even with the rapid development of modern medicine. Somebody uses them because he believes in the miraculous power, someone- from mistrust to doctors. Without denying the positive effects of many medicinal plants in various diseases, I want to recall once again that tumors and similar processes – not the case when you need to indulge in such experiments.
Set a goal, you can find lots of recipes for home treatment with the use of Chelidonium, cabbage leaf, pine branches and even moonshine. Usually these funds are proposed to be applied in the form of compresses on the region of hygroma. Often these impacts are recommended to be supplemented by kneading or even compression of hygroma.
Here it is worth considering whether effective medicinal plant in contact with the skin, in terms of education, located underneath? It does not cause the warming effect of increased blood flow and, consequently, additional production of fluid in the cavity of hygroma? What if hiromu crush, and its contents will be in the periarticular tissues?
At best, traditional recipes do not exacerbate the course of disease, at worst a cyst will get bigger, will develop complications, and then treat it will be much more difficult, so no need to go to extremes and waste time, much better consult a surgeon and once and for all forget about the ganglion cyst. Require anesthesia are extremely rare cases and carried out under local anesthesia, the operation will not create great discomfort and, especially, risk to life and health.
A ganglion cyst refers to those tumors that you can try to warn. For prevention of this disease, it is recommended to observe the motor mode, which eliminates the risk of injury and excessive stress on the joints. Athletes can help special bandages and protective device that prevents damage to the ligaments and tendon sheaths. If to avoid the appearance of cysts was not possible, then one need to go to the doctor, which will help to cure the ganglion cyst.