Ganglion cyst
| Ganglion cyst | |
|---|---|
| Specialty | Rheumatology  |
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 cyst can vary over time. It is most frequently located around the dorsum of wrist and on the fingers. The term "Bible bump" comes from a common urban legend that treatment in the past consisted of hitting the cyst with a Bible or another large book.[1]
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.
Treatment
If a ganglion cyst is symptomatic, it can be managed by aspiration or excision. Aspiration and injection of hyaluronidase into the cyst is the simpler of the two procedures, but cysts recur in more than 50% of cases. With surgery, the recurrence rate is reduced to only 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. During arthroscopy, the origin of the cyst can be seen within the joint.
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 "Jillian's lump", "Bible bumps" or "Gideon's disease."[1] This type of treatment is not recommended by some doctors as it can damage the area around the cyst and may have a higher recurrence rate than aspiration or excision.[citation needed]
Epidemiology
The epidemiology of ganglion cysts is not well studied, but some have stated that they occur most often in the 20–40 age group and are three times more common in women.[2]
