Ganglion 


11/25/2009

By José A. de la Osa 

Ganglion is a cystic tubercle that appears in the joints and on the membranes (sheaths) that line tendons. They appear in the wrists and in the hands and, less frequently, in the knees and feet. The term comes from Greek ganglia, which means “tissue node”.

Because of its clinical experience Dr Eduardo Acosta Alonso considers that a ganglion disorder is one of main consultation reasons in Orthopaedics and Traumatology.

—Do these protuberances (almost round prominences and lumps) have a benign nature?

—In 100 percent. I can categorically affirm that in any case ganglia have a cancerous nature.

—Does science know what causes them?

—It’s unknown at present. Some authors refer to a traumatic origin, as a result of lesions caused by mechanic agents, though it is not always like that. The most accepted ones are two theories linked to tissue degeneration and to a defect in the membrane that lines joints and tendons. .

—Do they appear more frequently in men or in women, and at what age on average?

—There’s certain “preference” for women, but ganglia appear at any age, although they’re more common in the second decade of life and at age 50. You seldom see them after these ages.

—Do they have a quick or slow growth?

—Oddly, these swellings use to appear gradual or suddenly, from one day to the other, and may disappear without any treatment. When the latter happens, they almost always reappear. 

—Are they visible in every people?

—Generally, they’re almost always visible, though at times it’s possible to detect them through palpation.

—What are, so to say, their main manifestations?

—Ganglion forms gradually or suddenly, is sometimes painful, is attached to deep tissues and may limit joint or tendon mobility, according to its location.

—What do you consider the most adequate moment to consult a doctor and what physician to go to?

—Right at the moment when it appears we should go to our primary health care services.

—Does the diagnosis require complementary exams or the final conclusions are only drawn through the clinical analysis?

—The diagnostic certainty is usually established through the clinical exam: to listen to the patient, to question and to exam him. The specialist can suggest a radiography to discard the presence of some disorder in the neighbouring joints.

—Are there specific therapies?

—Initially, the physician can follow a conservative treatment aimed at the observation and follow-up of the development of the ganglion. Now then, it is possible to carry out the aspiration of the cystic fluid through a syringe, or to extirpate it by surgery, which is the procedure we prefer to practice at our Orthopedics and Trauma Service.

—According to your knowledge, what patients have greater requirements of surgery?

—Mainly those who are in pain, have limitations in their daily activities, including the professional ones, or even when it is advisable for the patient from the aesthetic point of view.

—Is surgery practiced ambulatorily?

—Yes. It is aimed at the elimination of the cyst, which includes part of the joint capsule or tendinous membrane that causes the disorder.

—A while ago you said that ganglia, which disappear spontaneously, tend to reappear. Do they behave the same when they are surgically extirpated?

—Yes, they often reappear too.

Cubasi Translation Staff

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