Have a lump in your joint? - Be alert for ganglion cysts
Orthopedic surgeons often meet patients with lumps in the wrists, ankles, fingers, and toe facet joints, and after ultrasound examination, it is found that most of the masses are ganglion cysts, and some patients are very worried, what should I do? Today, I will briefly talk about ganglion cysts.
What is a ganglion cyst
Ganglion cysts, which are small sacs of fluid that form on joints or tendons, are benign cysts with a high incidence rate. It usually occurs on the dorsal side of the wrist, finger joints and dorsum of the feet, and can also be formed in the knees, shoulders, back and other parts.
It usually appears as a single large cyst that generally does not pose a serious health hazard to the patient. Ganglion cysts can occur at any age, but 70% of them occur in young adults between the ages of 20~40, and most of the patients are women.
Causes of the formation of ganglion cysts
There are currently three hypotheses regarding the formation of ganglion cysts:
1. Acute or chronic joint pressure increases lead to the rupture of the joint capsule, and the synovial fluid enters the surrounding tissues through the crack, and then the outflow of synovial fluid and the surrounding tissues interact with each other to produce colloidal sac fluid and cyst wall.
2. Intra-articular pressure leads to mucinoid degeneration of extra-articular connective tissue, followed by accumulation of cyst fluid, cyst formation, and finally the cyst communicates with the joint through the pedicle.
3. Intra-articular pressure stimulates mesenchymal cells to secrete mucin.
Clinical signs of ganglion cysts
Ganglion cysts usually appear as localized, round, hard or tough masses that may fill the cyst cavity with a viscous, gelatinous fluid.
Ganglion cysts are usually painless, slow growing, and may be mildly tender. Sometimes the location of the cyst can also affect the movement of the joint or cause muscle weakness. More than half of patients with ganglion cysts on the back of the wrist have no pain symptoms or only mild tenderness and numbness, so most patients can not be treated without affecting daily life; Some patients actively seek treatment because of a change in appearance or fear of deterioration.
Treatment of ganglion cysts
Conservative treatment: Treatment is usually done by rupturing the cyst by pressing (e.g., by acupressure, heavy pressure, etc.) or by suction/injection, which is followed by the injection of sclerosing agent after aspiration. Because these methods do not destroy the cyst itself, it is highly susceptible to recurrence. However, because conservative treatment is not traumatic to patients, it is convenient and fast, and the complication rate is low, so it is the preferred method for some patients with mild symptoms.
Surgical treatment: For patients with repeated recurrence or cyst enlargement and pain, surgical resection can be performed after local anesthesia, which can reduce the recurrence rate by 76% compared with conservative treatment, but it does not guarantee no recurrence.
Contributed by: Department of Ultrasound
Editor: Advocacy Section