Editing Ganglion cyst


== Pathophysiology ==

* Fluid-filled swelling overlying a joint or tendon sheath
* Thought to arise from a herniation of dense connective tissue
* Contain thick gelatinous fluid
* 70% from dorsal wrist (mostly from radiolunate ligament)
* 20% from volar wrist over scaphotrapezoid ligament
* Others over A1 pulley
* Digital mucous cyst is a ganglion that forms over dorsal DIPJ - these ones are usually a/w osteoarthritis
* But can technically occur pretty much anywhere on the body

== Diagnosis ==

* Should transilluminate
* USS can add clarity if in doubt
* MRI is very good at diagnosis if still in doubt

== Differential ==

* Tenosynovial giant cell tumour 
* Epidermoid cyst
* Lipoma
* Infectious tenosynovitis
* Rheumatoid nodule
* Tendinous xanthoma
* Tophus
* Synovial sarcoma

== Treatment ==
Aspiration - worth trying, although 50% recur

* 18G needle

Injection with steroids - UTD says not worthwhile

Surgery

* Persistent or recurrent symptoms despite initial conservative management
* 10% recur

[[Category:Skin, soft tissue and wounds]]