Everyone is prone to introspection and self-examination. Many of us often think that a colleague or neighbor is more perfect in appearance, healthier or more beautiful. But when we get to know and get to know a specific person better, we understand that it just seems, and each, at first glance, a beautiful and healthy person has his own shortcomings, including physical ones, for example, neoplasms on the hands or body, carefully hidden by fashion items from the latest collections of famous designers.

To improve, you need to see your imperfections and have a desire to become better.

Today we will talk about such neoplasms on the human body as hygromas, ganglia and synovial cysts.

So let’s figure it out.

HYGROMAS, GANGLIA, SYNOVIAL CYSTS: WHAT ARE THEY?

Hygromas, ganglia, synovial cysts are tumor-like neoplasms on the human body.

Hygroma is an accumulation of fluid in the serous bag above the joint, sometimes with an admixture of fibrin or mucus. It can be clear, gelatinous, rather dense, or watery.

Ganglia are benign, neoplastic, cystic neoplasms that occur in the area of ​​tendon sheaths or joints. Most often, the tendon ganglion forms on the dorsum of the hand, but cases of hygroma of the knee joint are also quite common, less often on the dorsum of the foot.

A synovial cyst is a benign tumor that is filled with fluid. Localized, as a rule, similar neoplasms on the wrists, lower legs and spine. Often, such growths accompany arthrosis.

ETIOLOGY OR CAUSES OF OCCURRENCE

The exact reasons for the formation of ganglia and hygroma have not been established.

In medicine, there are several theories explaining the reasons for their occurrence. Doctors speculate that the swelling is due to trauma. Joint damage leads to the formation of small cavities in the cartilage and tendon tissue, which then fuse into one.

The most likely causes of hygroma of the wrist or other joints are congenital tissue weakness in the joint capsule and the accumulation of intra-articular fluid in it, progressing under the influence of microtraumas, for example, during physical exertion or working at a computer.

Hygroma of a tendon or joint develops slowly.

It does not reach gigantic proportions and does not turn into a malignant tumor. However, complications are possible in the development of the disease. They are associated with an increased risk of trauma to the formation, difficulty in movement in the limb, accidental infection of the hygroma in case of damage to the skin, and a cosmetic defect.

As for synovial cysts, the reasons for their occurrence are different:

* sports or domestic injuries;

* osteoporosis;

* infectious diseases;

* arthritis;

* joint instability;

* congenital genetic predisposition.

LOCALIZATION OF NEOPLASMS

It should be noted that most of the ganglia is an isolated pathology.

About 65% of the ganglia of the wrists and hands develop in the navicular-semilunar joint, on the back of the wrist. In approximately 20-25% of cases, ganglia are localized on the palmar surface of the wrist, in the region of the distal radius. 

The remaining 10–15% are represented by flexor tendon sheath ganglia and mucosal cysts (formed from the dorsal part of the distal interphalangeal joint).

It is important to note that this pathology can spontaneously regress.

TYPES OF HYGROMA

Neoplasms are classified according to their location:

* the back of the wrist and fingers on the hand in the muscle area (carpus radialis brevis) – 88%;

* ankle and foot – 11%;

* knee in the area of ​​the cruciate ligaments, under the patella, at the beginning of the tendon of the gastrocnemius muscle;

* neck and shoulder in the area of ​​articulation of the acromial end of the scapula and the clavicle or biceps tendon.

In addition to external hygromas, in very rare cases, the internal location of the tumor is observed, for example, in bone, muscle, or even in the spine.

SYMPTOMS

The tendon ganglion is not considered dangerous, but it can cause pain when the tendon works and often becomes quite noticeable visually, and in advanced stages, squeezing of blood vessels begins, which leads to stagnation of blood in the veins and pain. On palpation, the ganglion is defined as a tumor-like, rounded and sedentary formation with clear boundaries. It occurs in the area of ​​the joint and has a firm-elastic consistency.

When the tendon ganglion is still small, the patient usually does not experience any discomfort.

Symptoms of a ganglion or hygroma are:

– a swelling or a ball that is soft to the touch, which can either increase or decrease;

– sudden edema in the area of ​​hygroma;

– the hygroma may appear and disappear again for a while;

– sometimes in one place several hygromas are formed at once, but usually they are interconnected in the depths of the tissues;

– in the hygroma, some painful sensations may occur, especially after an injury;

– sometimes the pain is chronic and can be aggravated by movement;

– if the hygroma is associated with a tendon, then the affected muscle usually feels weaker. For example, a finger cannot fully move if there is a hygroma at its base.

DIAGNOSIS OF CYSTIC FORMATIONS

* Inspection

Ganglia are identified by physical examination. Another type of dense formation on the back of the wrist develops in patients with rheumatoid arthritis; it is easy to differentiate due to its soft, uneven contours and its association with proliferative rheumatoid extensor tenosynovitis.

Diagnosis of the ganglion is usually straightforward. However, if the ganglion is small and located deep under the ligament, it may not be diagnosed for a long time or may be mistaken for another disease. Sometimes the pain occurs before the swelling characteristic of the ganglion has developed, which can also lead to a diagnostic error.

At the appointment, the doctor asks the patient about the medical history, its symptoms and performs an examination. Most ganglia are recognized based on their appearance and location. Sometimes an examination is not enough to make an accurate diagnosis. In this case, the doctor has a fairly wide scope for choosing a diagnostic method. 

He can order the following studies:

* X-ray examination. This method allows you to determine the nature of the neoplasm and carry out differential diagnostics with other similar pathologies;

* Ultrasound of the tumor and adjacent tissues is performed in order to distinguish a non-bone tumor from a cyst. 

* In this case, it is possible to determine what kind of cyst it is: consisting of one chamber or many;

* CT. It is the most advanced of X-ray methods to determine the connection of the tumor with the bone, synovial sheath or joint. The most accurate should be recognized as the method using a contrast agent. It allows you to identify the degree of vascularization of the neoplasm. It is known that high vascularization is a sign of malignant neoplasm;

* puncture – pumping out fluid from the ganglion cavity using a special needle, after which the resulting material is sent to the laboratory for histological examination. Histological data are necessary in order to distinguish hygroma from other similar benign and malignant tumors. In some cases, fluid evacuation is one of the treatment options leading to recovery.

Most often, a hygroma needs differential diagnosis with a lipoma (wen), atheroma and lymphadenitis. In order to avoid mistakes and make the correct diagnosis, it is important to perform the above studies that will help you understand in a given situation. Therefore, it is important, as soon as you discover your education, to seek help from a surgeon or orthopedist, who will perform the necessary range of examinations and prescribe the appropriate treatment. 

You can undergo such an examination in our Ladisten Clinic, where experienced highly qualified orthopedic surgeons will help you to accurately differentiate the type of neoplasm and provide professional medical assistance in each specific case.

TREATMENT OF CYSTIC FORMATIONS

* Aspiration or removal if discomfort is present

Most ganglia require no treatment. However, it is necessary if there is pain in the area of ​​education or the patient is worried about his appearance.

It should be noted that aspiration is effective in 50% of cases. Attempts to crush the ganglion with a hard object are rarely effective and pose a risk of local injury. 

There are such conservative methods for treating hygroma:

* mechanical crushing. It is used for small hygroma sizes. It is accompanied by soreness, a high probability of reappearance of a hygroma, and the risk of developing an inflammatory process. The fact is that when crushed, the contents of the hygroma are poured into the surrounding tissues, which in the future can even lead to suppuration. In addition, the damaged membrane is able to recover after a while, which can lead to the emergence of a new hygroma;

* puncture of the hygroma. The essence of the method is to pump out the liquid from the hygroma cavity, after which the cavity is filled with special preparations that contribute to the hardening of the hygroma capsule. 

* The method is used both with a therapeutic purpose, if for some reason it is impossible to perform surgical removal, and with a diagnostic one (the contents of the ganglion obtained by puncture are sent for research).

These methods of treatment are currently not used, as they are accompanied by a high risk of relapse. It has been proven that as a result of treatment with a conservative method, in 75% of cases, after a while, a person again turns to a medical institution for help in connection with the emergence of a new hygroma.

It is worth noting that surgical removal is not in all cases able to completely eliminate the disturbing problem, however, the risk of recurrence is significantly reduced and amounts to 15%. Despite the fact that at present they have abandoned the conservative method of treating hygroma, in some cases they are still used. For example, with the patient’s absolute refusal from surgical intervention.

During the operation, the ganglion and all of its membranes are removed.

In most cases, the operation is performed under local anesthesia, which consists in injecting a local anesthetic into the surrounding tissue near the hygroma. The duration of the operation is approximately 30 minutes. At the end, stitches are applied. The healing time ranges from 10 to 15 days. To reduce the risk of reappearance of the hygroma, which patients are very afraid of, a plaster cast is applied. This is necessary for firm fixation of the operated area of ​​the limb, because movement of the limb in the area where the ganglion was should not be allowed. The plaster splint is removed after 2 weeks, during which time a scar is formed. 

For some time now, when removing the hygroma, the scalpel was replaced with a laser beam, which has both a number of advantages and negative consequences in the form of a relapse of the disease.

Conservative treatment is ineffective in 40–70% of patients. Removal can be done arthroscopically or with standard open surgery.

As for drugs, they can prescribe pain relievers (analgin, diclofenac) in the postoperative periods if there is strong pain. In addition, they have an anti-inflammatory effect, which is also important in the postoperative period.

CAN HYGROMAS BE PIERCED?

The hygroma can grow in size, and then it often becomes painful. Patients often ask: is it possible to pierce the hygroma? We answer.

Conservative treatment of hygroma is ineffective, since a puncture (puncture) helps only for a while. 

The only effective way to get rid of a hygroma forever is an operation – surgical removal of the neoplasm, which you can successfully do at the Ladisten Clinic medical center.

FORECAST

The recurrence rate after surgical excision of the ganglion ranges from 5 to 15%, depending on the individual characteristics of each person.

Awareness of one’s imperfection brings one closer to perfection.

At Ladisten Clinic, we will be happy to help you become healthier by diagnosing and eliminating all neoplasms, and, accordingly, better!!!

We are always glad to see you!

Your “Ladisten Clinic”.

 

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