Ganglion cyst
| Ganglion cyst | |
|---|---|
| Classification and external resources | |
 Cyst on right wrist |
|
| ICD-10 | M67.4 |
| ICD-9 | 727.4 |
| DiseasesDB | 31229 |
| eMedicine | orthoped/493 |
| MeSH | D045888 |
A ganglion cyst, also known as a bible cyst, is a swelling that often appears on or around joints and tendons in the hand or foot. The size of the ganglion or cyst can vary over time. It is most frequently located around the dorsum of the wrist and on the fingers. The term "Bible bump" comes from a common treatment in the past that consisted of hitting the cyst with a Bible or another large book.[1] Rupture of the cyst is rarely curative; trying to pop it typically does not fix it but in fact worsens it.[citation needed]
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[edit] Cause
Ganglion cysts are idiopathic, but presumably reflect a variation in normal joint or tendon sheath function. Cysts near joints are connected to the joint and the leading theory is that a type of check valve forms that allows fluid out of the joint, but not back in. The cyst contains clear fluid similar to, but thicker than, normal synovial fluid. They are most often found around the wrist joint, especially at the scapho-lunate joint, which accounts for 80% of all ganglion cysts.
[edit] Treatment
With surgery, the recurrence rate is reduced to 5 to 10% if the check valve at the joint capsule is removed. Arthroscopy of the wrist is becoming available as an alternative to open excision of ganglion cysts.
Alternatively a needle may be used to drain the fluid from the cyst (aspiration), however if the fluid has become thick due to the passage of time this treatment is not always effective.
A 6 year outcome study of treatment of ganglia on the back (dorsum) of the wrist compared excision, aspiration and no treatment. Neither excision nor aspiration provided long-term benefit over no treatment. 58% of the untreated ganglia resolved spontaneously, the post-surgery recurrence rate in this study was 39%.[2]
A similar study in 2003 of palmar wrist ganglion found "At 2 and 5 year follow-up, regardless of treatment, no difference in symptoms was found, regardless of whether the palmar wrist ganglion was excised, aspirated or left alone." [3]
An out-dated method of treating a ganglion cyst was supposedly to strike the lump with a large heavy book, causing the cyst to rupture and drain into the surrounding tissues. An urban legend states that since even the poorest households often possessed a Bible, this was commonly used, which led to the nicknaming of ganglion cysts as "Bible bumps" or "Gideon's disease."[1]
[edit] Image gallery
[edit] See also
[edit] References
- ^ a b http://www.eatonhand.com/hw/hw013.htm
- ^ Dias JJ, Dhukaram V, Kumar P, The natural history of untreated dorsal wrist ganglia and patient reported outcome 6 years after intervention. J Hand Surg Eur Vol. 2007 Oct;32(5):502-8.
- ^ Dias J, Buch K. Palmar wrist ganglion: does intervention improve outcome? A prospective study of the natural history and patient-reported treatment outcomes. J Hand Surg Br. 2003 Apr;28(2):172-6.
[edit] External links
- American Academy of Orthopaedic Surgeons - Ganglions cyst of the wrist
- Canadian Centre for Occupational Health and Safety - Ganglion cyst
- eMedicine - Ganglion cyst
- Medscape - Ganglion cyst
- Ganglion Cyst- Prime Health Channel
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