Ganglion By Momen Ali Khan

Definition

Cystic swelling occurring in relation to tendon, synovial joint

Common site

Wrist joint- 90%Hand

Clinical featurePainless swelling

Pathogenesis

Cystic degeneration of the tendon sheath.Leakage of synovial fluid through joint capsule.There are small islets of microspaces in synovial sheathwhich often fuse together or one of them gets enlarged toform ganglion.

Examination finding

Smooth Tensely cysticFluctuating swellingTransilluminationFree from skinLess mobile when underlying structure contract

Differential diagnosis

BursaProtrusion of synovial cavity of arthritic jointLipoma.Lymph cyst.Sebaceous cyst.

ManagementAsymptomatic ganglion is better left alone because of highrecurrence rate. Excision-Usually done under local anaesthesia (lignocaine plain 2%). Patient should be explained of high recurrencerate (30%). After excision always it should be sent for histopathology.Firm crepe bandage application for 4 weeks isbetter in these patients. Aspiration and sclerosant injection may be useful.

Thanx