A B C D E F G H I J K L M N O P R S T U V W

GANGLION

What is a Ganglion ?

A ganglion is a small swelling which may appear near any joint or tendon (sinew). It is surrounded by a fibrous capsule (limiting membrane) which is attached to the deep tissues. The skin is not attached to the ganglion, which is filled with jelly-like fluid. Ganglia may appear either gradually or suddenly and they occasionally develop after an injury. A change in size is common and they may disappear, only to reappear again. They most commonly occur on the back of the wrist close to the tendons to the thumb and index finger: here they are much more obvious when the wrist is bent. The front of the wrist is another common site. If they occur where the fingers meet in the palm, they are often small and very tender. Ganglia may also occur on the back of the foot or around the outside of the knee or ankle. Commonly a ganglion will cause aching discomfort before the swelling itself appears. This discomfort may be made worse by moving the nearby joint. Rarely, a ganglion can press on a nerve causing pins and needles, numbness or weakness.

Why does a Ganglion occur ?

Ganglia are thought to arise because of a tiny hole in the lining of joints or the sheaths which surround tendons. Sometimes this is caused by an injury. The tissue inside the joint or sheath pokes through this hole to form the ganglion. A number of cysts may develop through a single hole. Once the ganglion has formed, the channel between the joint and the ganglion usually disappears. Ganglia are more common in women and are rare over the age of 50 years. They are not related to occupation.

Treatment Involved for a Ganglion

If there is neither pain nor any other symptom, then treatment is usually unnecessary. If you have pain or tenderness, fluid can be withdrawn from the cavity of the cyst to reduce the pressure within it, using a needle and syringe. Then, through the same needle, an injection of steroid (cortisone-like drug) with local anaesthetic is given. This procedure may be repeated on a second occasion, if initially unsuccessful. If this still fails, or the ganglion comes back, an operation is usually needed. This involves cutting out the ganglion, at the same time repairing the underlying hole or defect. This operation is more likely to be carried out under local rather than general anaesthetic. The choice of anaesthetic type depends on where the ganglion is. A cut is made over the swelling, which is then carefully shelled out. The skin is closed and the area is bandaged. Plaster of Paris immobilization is occasionally used.

During Treatment for a Ganglion

After injection, discomfort may either develop or worsen, for only 24 to 48 hours. The ganglion then gradually shrinks and disappears. This treatment is successful in as many as half the cases. After an operation, no further treatment is necessary once the wound has healed and the stitches have been removed. However, there is about a 1 in 10 chance that the ganglion may come back. This is due to the fact that multiple cysts are often present. Complications following operation are rare. Occasionally blood may collect in the wound area, causing a swelling. This usually gets better gradually without treatment. Damage to nerves or blood vessels may sometimes occur, causing temporary pain and sometimes permanent numbness. If the wound becomes infected, it is usually red and sticky, with some discharge. You should tell your doctor about it.

If a Ganglion is Left Untreated

Ganglia change in size or may disappear by themselves. There are usually no serious consequences if they are left untreated.