A ganglion is a benign cyst, i.e. a fluid-filled cavity. It usually forms near joints or tendons. A ganglion looks like a ball or bump and rarely causes pain or other discomfort. A ganglion often disappears by itself. If this is not the case, a small operation can help.
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The ganglion (ICD code: M67.4) is generally known as a ganglion . However, this term is misleading, as a ganglion is not an additional growth of bone material.
A ganglion is a cyst that forms on a joint or tendon. A cyst is an outward protrusion of the synovial membrane. As this protrusion is connected to the joint cavity, a cavity filled with joint fluid (synovial fluid or synovia) is formed, which can be felt from the outside through the skin as a lump. The ganglion is easy to move, soft and painless.
From the outside, a ganglion resembles a bump that is a few millimetres to centimetres in size. A ganglion can reach the size of a pea or cherry.
On the inside, where the ganglion originates under the skin, it consists of a capsular stalk and a capsular bulge.
The ganglion is basically benign - so there is no risk of the ganglion degenerating. The ganglion is therefore not a tumor.
Ganglion on the wrist © Yulia | AdobeStock
Ganglions occur most frequently
occur. Around two thirds of all cases involve a wrist ganglion.
Also possible, but much rarer, are ganglions
Doctors also differentiate between
A ganglion often develops in the hand. © Henrie / Fotolia
The formation of a ganglion can have individual causes. In most cases, such a cyst develops due to incorrect or excessive strain on the joint or weak connective tissue.
If the connective tissue is weak, cracks and protrusions can form more easily in the tendon sheath or joint capsule. Joint fluid then leaks out and collects in the resulting enlargement. The fluid can therefore not drain back and a ganglion forms.
People of all ages can develop a ganglion, although women seem to be affected more frequently due to their often looser connective tissue.
There are certain risk factors for a ganglion. These include, for example
Uniform movements favor a ganglion. Some sports, certain hobbies or manual work are therefore particularly predestined for the formation of a ganglion.
Prevention is possible through a healthy lifestyle. This helps to avoid pathological changes to the musculoskeletal system from the outset. This includes healthy movement patterns and a sensible balance between rest and exertion.
Monotonous or one-sided stressful activities can promote the development of a ganglion, particularly in the wrist.
In many cases, a ganglion does not cause any symptoms. In this case, the ganglion is primarily a cosmetic blemish.
The symptoms that occur depend primarily on the affected area and the location of the ganglion.
For example, a ganglion that exerts pressure on the tendons can severely impair the mobility of joints and muscles. The ganglion can also squeeze nerve tracts and blood vessels. In this case, those affected suffer from
A ganglion can be recognized with the naked eye as a small bump. These other signs are typical of a ganglion:
If you experience these symptoms, particularly neurological deficits, you should seek medical advice. Talk to your family doctor or go directly to an orthopaedic specialist. It is advisable to consult a specialist - for example, a hand surgeon if the ganglion is located on the hand.
A detailed medical history and subsequent palpation of the affected area are usually sufficient for the diagnosis. Important questions are
If you have noticed any other ulcers or swellings on your body, you should definitely mention this during the medical consultation.
This will be followed by a physical examination, during which particular attention will be paid to the ease with which the lump can be moved and the absence of tenderness.
The following abnormalities will also be investigated:
Ultrasound (sonography) can then be used to check whether the swelling is filled with fluid or contains other tissue structures, such as fatty tissue or calcifications.
An MRI is only used in exceptional cases - usually to rule out other diseases. For this purpose, a pathological examination of the fluid and swelling in the laboratory is also possible.
Conservative therapy can be supported with ointments and embrocations. Horse ointment or arnica creams, for example, have proven effective. As the ganglion is not caused by inflammation, you do not need to apply any special anti-inflammatory agents.
Also
can also help to reduce the size of the ganglion or make it disappear completely.
If the ganglion is not accompanied by any symptoms, no treatment is actually necessary. In principle, a ganglion can regress on its own, i.e. spontaneously. It may therefore be sufficient to observe the ganglion and be patient. After about three months, the ganglion may have completely regressed.
Under no circumstances should you apply force to the ganglion or even cause it to burst, as this can cause it to become inflamed.
If a ganglion does not regress on its own, there are two treatment options:
In aspiration , the ganglion is punctured with a fine needle. The removed fluid significantly reduces the size of the ganglion. The fluid can also be examined under a microscope and the diagnosis confirmed.
A sclerosing substance (e.g. ethanol or a corticosteroid) can then be injected into the resulting cavity. Ideally, this will seal the cavity and prevent new fluid from leaking in. However, this treatment usually has to be repeated several times in order to achieve lasting success.
If the ganglion causes severe pain or the patient suffers emotionally from the ganglion, surgical removal may be considered. This procedure, which is usually performed on an outpatient basis, can be carried out either in the traditional way via a skin incision or minimally invasively.
The chances of success are very good if the ganglion can be removed without leaving any residue.
However, complications are to be expected, especially in the case of surgery with a large incision, for example
In contrast, puncture and aspiration only cause problems in two percent of all cases.
Whether aspiration or surgery: even after successful treatment of the ganglion, it can reappear in the same place. If the ganglion was caused by monotonous (uniform) movement patterns and incorrect loading, the best prevention is to avoid these overloads.
A ganglion is harmless - however, it is advisable to have a medical examination if you suspect a "ganglion". A diagnosis can then be made and suitable treatment initiated.
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