ganglion cyst.pptx

Describes benign swellings on upper limb especially on wrist

1. GANGLION CYST

2. ROAD MAP INTRODUCTION /DEFINITION EPIDEMIOLOGY RISK FACTORS PATHOPHYSIOLOGY SIGNS AND SYMPTOMS DIFFERENTIAL DIAGNOSIS DIAGNOSIS MANAGEMENT COMPLICATIONS CONCLUSION

3. INTRODUCTION A Ganglion cyst is a small sac of fluid that forms over a joint or tendon. Inside the cyst is a thick, sticky, clear, colorless, jellylike material. Depending on the size, cyst may feel firm or spongy. They most commonly show up on the back of the hand at the wrist joint but they can also develop on the palm side of the wrist, the knee and ankle.

4. EPIDEMIOLOGY Ganglion cysts are the most common soft-tissue tumors of the hand and wrist. Although anyone can be affected by ganglion cyst they occur three times as often in women as they do in men. They are most commonly seen in older patients ages 20-40 and above. They are comparatively rare in children. They tend to occur more frequently in people who repeatedly stress their wrists, such as gymnasts.

5. RISK FACTORS Injury to the wrist or finger Inflammation in a joint or tendon Repetitive wrist or finger activities Chronic conditions like arthritis Sex (females) Age (20-40 years)

6. Pathophysiology of ganglion cyst Ganglion cysts are benign soft tissue tumors most commonly encountered in the wrist on the dorsal aspect and communicate with the underlying joint via a pedicle. Analysis of cystic fluid reveals that it is a gelatinous material containing mainly hyaluronic acid and lesser amounts of glucosamine, globulins and albumen. This fluid is different biochemically and is much thicker than intra- articular synovial fluid. The origin of the fluid has not been fully elucidated, but it has been postulated to arise from one of three mechanism. First it may originate from within the joint, pumped into the cyst by motion of the wrist

7. Continuation.. Secondly from an extra- articular degenerative process resulting in cyst formation and subsequent communication to the joint. Finally it may originate from mesenchymal cells within the cell wall. It is possible that a combination of these mechanisms contribute to the ganglion cyst.

8. Signs and symptoms Swelling that may appear over time or suddenly A soft bump or mass that changes size but doesn’t move. Weakness when it is connected to a tendon Pain if the cyst presses on a nerve Numbness if it presses on a nerve Limited range of motion

9. Differential diagnosis Tenosynovitis Lipoma Osteoarthritis Sarcoma Giant cell tumor of tendon sheath

10. diagnosis Investigations; Most ganglion cysts are diagonised clinically A plain xray film may assist ruling out osteoarthritis or bone malignancies Ultra sound and MRI is done inorder to asses the shape, size and depth of the cyst. Aspiration for microscopy CT scan to rule out malignancies

11. Management If the cyst does not cause any pain, the usual recommended treatment is to simply monitor, as cysts often disappear spontaneously without further intervention If the cyst causes pain or severely limits range of motion, there are two main interventions that can be performed. 1. Aspiration: with this procedure, a needle is placed into the cyst to draw the liquid material out. The steriod compound(anti-inflammatory) is injected into the area and the area is put in a splint to keep it from moving. Aspiration doesnot remove the area that attaches the cyst to the joint, so they often return.

12. Continuation…. Surger y:With this procedure ,the cyst and area around it that attaches it to the joint is excised.

13. complicatins