Ganglion cyst

undergraduate series orthopedics

1. GANGLION CYST NUR FARRA NAJWA BINTI ABDUL AZIM 082015100035

2. LEARNING OBJECTIVE By the end of seminar, student should be able to Explain what is ganglion cyst Know the finding in ganglion cyst and what investigation to be done Describe the management for ganglion cyst

3. INTRODUCTION Ganglion Small cystic swelling filled by mucin Also known as Bible cyst C ommon in women, and 70% occur in people between the ages of 20-40. Rarely , ganglion cysts can occur in children younger than 10 years.

4. Cont. Commonly occur on the back of the hand at the wrist joint but they can also develop on the palm side of the wrist. On the back of the wrist, they become more prominent when the wrist is flexed forward. Other site (less common) The base of the fingers on the palm (small pea-sized bumps) The fingertip, just below the cuticle, where they are called mucous cysts The outside of the knee and ankle The top of the foot

5. ETIOPATHOLOGY NOT A TRUE CYST! Theory of formation Synovial herniation Mucus cyst formation Degeneration of connective tissue and cyst formation

6. CLINICAL FEATURE Common in female Size show variation with time Intermittenly painful, usually following acute or repetitive trauma, Up to 35% are without symptoms except for appearance. Pain Chronic Made worse by joint motion. When the cyst is connected to a tendon, weakness in the affected finger.

7. Cont. INSPECTION Swelling on dorsum of wrist (sometimes on volar aspect) Pea size ( occassionally larger) PALPATION Very firm/bony hard Wrist ROM normal

8. A traumatic ganglion cyst. This person came to the emergency department with a painful bump after the wrist was hit by a car door. The jellylike fluid taken from the cyst in Image 1 . Its presence confirms the diagnosis of a ganglion cyst.

9. A ganglion cyst that has been operated on in the past. This ganglion returned because this person plays the cymbals in her school band An ultrasound image shows the ganglion cyst ( area between markers ) from Image 1. 1

10. INVESTIGATION Ultrasonography Confirmation by using ultrasound. Determine whether the bump is fluid-filled (cystic) or if it is solid. Detect whether there is an artery or blood vessel causing the lump. MRI To see the wrist Drawback is the cost of the procedure Refer to a hand surgeon Large or solid Involves a blood vessel (artery).

11. MANAGEMENT

12. BULLET POINT !! Commonest cystic swelling on the dorsum of the wrist. Mucoid degeneration of the tendon sheath or the joint capsule. No symptoms other than the swelling Mild discomfort or pain. Aspiration of the cyst and an injection of hylase given. Recurrance , excision .

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