Ganglion cyst

A ganglion ( colloquially as other similar-looking phenomena inaccurately referred to as a leg ) is an emerging single or multiple, benign tumor formation in the region of a joint capsule or tendon sheath superficial ( Sehnenscheidenhygrom ). The term " bone spur " is incorrect in using the term "leg" the consternation of a bone suggests (see nasal bone, heel bone ). A real bone spur is called exostosis.

Causes

The reason for the development is usually unknown; an overuse of the corresponding structures with chronic irritation, but also a spontaneous formation is assumed. Typically, an outgoing of a joint capsule ganglion has always been a small, pedunculated connection to the joint space through which a fluid exchange between the two structures is possible. So there is for example in the context of an activated arthrosis a joint effusion, so changes - depending on the joint position - the stress state of the joint capsule, which is the internal pressure in the joint and a ganglion can thus more or less complete. In the area of joints can occur through a ganglion as a protuberance of the inner sheet of the joint capsule ( synovium ) by weaknesses in the outer ( membrana fibrosa ).

Occurrence

When a ganglion is a frequent, benign tumor, extend-sided or beugseitig on the wrist or on the finger joints ( ring band ganglia). Rare ganglion on the foot ( instep ) or the knee is localized, in some cases also in the area of the elbow or the shoulder.

Symptoms

As plump elastic, with viscous liquid ( Mycin ) filled expulsion of a joint capsule or tendon sheath can cause pain or restrict the mobility of a ganglion. For very large ganglia may lead to a compression of nerves and blood vessels. In case at the extreme, the last finger joint can deform by the mechanical pressure of the ganglion to the nail root of the nail. This form of the ganglion is also called Dorsalzyste.

Diagnosis

The diagnosis of a ganglion can usually already be provided by its location or shape. The overlying skin is displaceable on the other side there is a fixed connection to the joint or tendon sheath. Since, however, other changes may offer a similar picture, a confirmation of the diagnosis is usually necessary. This can be done for example by needle aspiration of the fluid, ultrasound, or surgical intervention. In normal radiograph a ganglion is not visible. The radiograph serves but to exclude bone prominence exostosis.

Therapy

First, however, in the cases that cause less discomfort, an immobilization of the region concerned are sought, so that the ganglion often regresses, with renewed overuse usually occurs again ( because, for example, a joint effusion increases again ).

Even a manual crushing of ( Pression ) on the ganglion may lead to success. Here, the ganglion can moderate pressure massage ( liquid is pushed back into the joint ) are associated with strong selective pressure to rupture or. In some cases, this form of therapy also lead to complete healing.

Another form of therapy is the puncture of the ganglion with aspiration ( suction ) of the contents. Often the interior of the ganglion fills but after some time, so that in general the operational restructuring is desirable.

The operation can be carried out both conventional endoscopy. In conventional surgery, the ganglion through a small possible access / cut is ( depending on the size of the ganglion ) removed together with its stalk. Performs to the corresponding operation endoscopically, the instruments over 2-3 small incisions are introduced. In both surgical procedures may in 20-30 % of cases, to a recurrence of the disease (relapse ) can occur.