מהו גנגליון?

Ganglion is the most common benign tumor in the palm and fingers. It's actually a kind of sack that comes out of the joint and is filled with viscous liquid that can be very stiff or viscous like rubber. The source of the fluid that fills the bag is in the joint adjacent to the place of hatching or in the mantle of a nearby tendon. Ganglions can appear in several locations at the wrist: at the back of the wrist, in the wrist dorsal aspect - usually near the origin of the wrist, at the back of the small joints of the fingers or at the base of the finger as a small "marble". The ganglionic cyst is absorbed and grows according to the load placed on the limb.

The cause of ganglion development is not necessarily known. However, an area of weakness in the tendon or joint is the common cause of ganglion.

What is typical of ganglion?

The most common finding is an unclear swelling of the palm. Typically, the cyst appears relatively fast - and can be absorbed quickly as well. Sometimes, the ganglionic cyst will cause pain and sometimes the ganglion can even press on a blood vessel or nearby nerve and affect the sensation in the hand or the blood supply nearby.

How is Ganglion diagnosed?

The initial diagnosis will usually be made by the primary physician in the physical examination according to the typical size and location. I recommend assessing the location and size of the ganglion with the help of a guided ultrasound test and in some cases an x-ray to complete the ganglion assessment.

Ganglion treatment

First, there is no obligation to treat the ganglion - you can definitely diagnose the finding and learn to live with it safely. Sometimes the ganglion is absorbed by itself and can sometimes be eliminated only with local pressure.

I recommend doing at least one evacuation of the joint in most cases. Sometimes I incorporate a local injection into the ganglion with cortisone injection, sometimes I do a puncture along with the injection and sometimes even recommend going back and doing some evacuation to avoid surgery.

In cases where the ganglionic cyst refuses to be absorbed, I recommend performing a cystectomy. The surgery can be performed in a number of approaches - and wrist arthroscopy can also be used for this purpose. In most cases, and when choosing an experienced and skilled hand surgeon the recurrence rates are low.

‏בתמונה שלפניו אפשר לראות גנגליון שלמעשה משפיע ומשנה את הצורה של הציפורן. הגנגליון שמשפיע ומשנה צורה ציפורן גורם לכך שבסופו של יום הציפורן מתעוותת ולמעשה כדי לשפר את צורת הציפורן עלינו לכרות את הגנגליון. במקרה שלפנינו הגנגליון עבר צריבה עם חנקן נוזלי אבל זה לא פטר את‏ הבעיה. למעשה מה שקורה בסופו של יום שגנגליון כזה מחייב ניתוח בידי מנתח כף יד מומחה ומיקרוכירורג מה שיאפשר בסופו של יום החלמה וחזרה של הציפורן למצב תקין.

בתמונה רואים ציסטה אשר נמצאת באצבע אשר התנהגה כמו אצבע הדק אבל גרמה לכאב ניכר. זוהי ציסטה אשר היתה באזור הגלגלת של של האצבע. ציסטה גנגליונית זאת נכרתה וכך נמנע הכאב.

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