What is Ganglion Cyst?
Ganglion cyst is a lump or tumor at the top of the joint or tendon (the connective tissue of the muscles and bones). This ganglion lump cyst looks like a bag filled with clear fluid with a thick, sticky texture like jelly, also called synovial fluid.
The size of ganglion cysts vary, from as small as peas to the size of a golf ball. Small ganglion cysts usually amount to more than one, but they are linked by the same tissue under the skin.
Ganglion cysts are most common in the back of the hand right at the wrist, and usually the lumps will become more obvious as we bend the wrists down. Although rare, ganglion cysts may appear elsewhere such as the lower finger joints, fingertips (just below the nail), outer knees, ankles, or the back of the foot. Although ganglion cysts are harmless, this condition can sometimes be painful.
Ganglion Cyst Symptoms
Ganglion cysts symptoms are marked with the following:
- Location. Ganglion cysts most often appear in areas of tendons or joints of the hands. Other locations are also commonly encountered in the ankle and on the back foot. Although, ganglion cysts can also occur in other joints in the body.
- Shape and size. Ganglion cysts are generally round or oval with a diameter of less than 2.5 cm. Some ganglion cysts may not be palpable, because they are too small. If the affected joint is used continuously with repetitive motion, the size of the ganglion cyst may become larger.
- Pain. Ganglion cysts in general do not cause pain. However, if the cyst is to suppress the innervation, symptoms such as pain, tingling, numbness, or even muscle weakness may occur.
Causes and Risk Factors Ganglion cysts
The cause of the emergence of ganglion cysts is still not known with certainty to date. One theory says that ganglion cysts occur due to a trauma that resulted in tissues under the skin damaged. This collection of damaged tissue then forms small cysts that merge into one mass or larger lumps. Another theory suggests that ganglion cysts may arise as a result of damage to the tendon protector, so tissue in the tendon protrudes outward.
Several factors may increase a person’s risk of developing a ganglion cyst between:
- Female sex.
- Aged between 20 to 40 years.
- Has a history of joint and tendon injury.
- Osteoarthritis disease in the joints of the hands adjacent to the fingernails.
Diagnosis of ganglion cyst
Diagnosis of ganglion cysts can usually be established only by physical examination alone. On physical examination, the doctor may make gentle emphasis on the lump to look for any pain or discomfort. However, doctors may also perform follow-up examinations such as:
- Perform aspiration (fluid withdrawal) on the cyst using a needle, to then see the color, clarity, and viscosity of the liquid.
- Ultrasonography (USG), to see if the lump contains liquid or solids. With ultrasound, it can be seen also whether there are blood vessels involved.
- If the size of the lump is too large or to involve the blood vessels, your doctor may refer you to the surgeon.
- Magnetic resonance imaging (MRI) is the best tool to diagnose a ganglion. However, the cost is too expensive and often not necessary for simple ganglion cyst conditions.
Treatment of ganglion cysts
Most ganglion cysts will not cause symptoms so it does not require any treatment. But if the gangglion cyst in your body to cause pain to interfere with the activity, then the doctor may suggest you to do the following actions:
- Immobilization. The size of the ganglion cyst may be enlarged with recurrent activity in the affected area. Thus, the act of immobilization using splints can be one of the treatment options. However, the use of long-term splints is also not recommended, as it will cause muscle weakness. Therefore, consult your doctor about the most appropriate duration of use for your condition.
- Aspiration. Aspiration or withdrawal of this fluid can be used as a diagnostic as well as for therapy. The doctor will use a needle to draw fluid inside the ganglion cyst until the size of the cyst decreases or even disappears.
- Operation. Surgery is indicated when a lump causes pain, tingles, numbness, or interferes with daily activities (especially if the lump occurs in the dominant hand). There are two types of operations that can be done, namely:
- Open surgery. In this type of surgery, the surgeon will perform an incision of approximately 5 cm at the location of the joint or tendon with a ganglion cyst.
- Arthroscopic surgery. In this operation, the surgeon will make an incision with a smaller size. Then a small camera called an artroscope will be inserted into the incision to see the exact location of the cyst. The surgeon will then insert a device on the incision to remove the ganglion cyst.
Your surgeon will determine the type of surgery based on various considerations such as the location of the ganglion cyst, the type of anesthesia you choose, and what options are best suited to your condition.