Ganglion cyst

The average size of these cysts is , but excised cysts of more than have been reported. The size of the cyst may vary over time. Between 50 and 70% of all masses on the hand and wrist are ganglion cysts. Wrist They commonly are found near the wrist joint, especially at the scapholunate area. Common wrist ganglions include: • dorsal wrist ganglion • volar wrist ganglion • extensor retinaculum ganglion Lower extremity Ganglion cysts are not limited to the hands and feet. They may occur near the knee, mostly within and near the anterior cruciate ligament, Most patients with a ganglion cyst of the knee present with both pain and a restricted range of motion, but these findings are variable, and some patients may have neither. and are occasionally known to cause nerve compression or bone erosion. Rarely, intraosseous ganglion cysts occur, sometimes in combination with a cyst in the overlying soft tissue. It is possible for a cyst to be considerably displaced from the joint. In one extreme case, a ganglion cyst was observed to propagate extensively via the conduit of the common peroneal nerve sheath to a location in the thigh; in such cases surgery to the proximal joint to remove the articular connection may remove the need for a riskier, more extensive surgery in the neural tissue of the thigh. The cysts may intrude into the spine, which may cause pain and dysesthesia in distant extremities. One uncommon location of the cysts are in the muscle tendons of the hand, such as the extensor digitorum superficialis. Cyst_Profile2.JPG|Cyst on right wrist Ganglion Cyst on Foot.jpg|Cyst on dorsum of right foot Kyste420.jpg|Cyst on a finger Ganglion Cyst On Right Index Finger.jpg|Small cyst on right index finger Ganglion_cyst_lanced.JPG|small cyst on thumb lanced with red-hot needle File:Ganglion Cyst on the palmar side of the left wrist.jpg|Ganglion cyst on the palmar side of the left wrist ==Causes==

The exact cause is unknown. ==Diagnosis==

material - the walls are composed of bland fibrous tissue with no specialized lining.Normal sized Ganglion cysts are usually diagnosed easily, as they are easily visible and pliable to touch. For Ganglion cysts Medical imaging may be used to increase diagnostic confidence in clinically suspected lesions or to view smaller "occult" cysts as a cause of dorsal wrist pain with forceful extension. ==Treatment==

At least 33% resolve without treatment within six years, and 50% within 10 years. Surgical excision is the primary discretionary, elective treatment option for ganglion cysts. Alternatively, a hypodermic needle may be used to drain the fluid from the cyst (via aspiration). The recurrence rate is about 50% following aspiration of a ganglion cyst. Complications Complications of treatment may include joint stiffness and scar formation. ==Prognosis==

Recurrence rate is higher in aspirated cysts than in excised ones. Ganglion cysts have been found to recur following surgery in 12% to 41% of patients. A six-year outcome study of the treatment of ganglion cysts on the dorsal wrist compared excision, aspiration, and no treatment. Neither excision nor aspiration provided long-term benefit better than no treatment. Of the untreated ganglion cysts, 58% resolved spontaneously; the postsurgery recurrence rate in this study was 39%. A similar study in 2003 of ganglion cysts occurring on the palmar surface of the wrist states: "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." ==Etymology==

Being a misnomer that has persisted into modern times, the ganglion cyst is unrelated to the neural ganglion or ganglion cell; its etymology traces back to the ancient Greek , a 'knot' or 'swelling beneath the skin', which extends to the neural masses by analogy. Generally, Hippocrates is credited with the description of these cysts. == "Bible bump" ==

A historical method of treatment for a ganglion cyst was to strike the lump with a large, heavy book, causing the cyst to rupture and drain into the surrounding tissues. Historically, a Bible, usually the largest (or only) book in a household, was employed for this treatment. This practice led to the nickname of "Bible bumps" or "Gideon's disease" for the cysts. This treatment risks injuring the person and thus is not recommended. ==See also==