Ganglionic Cysts Flashcards Preview

Y3M - Trauma & Orthopaedics > Ganglionic Cysts > Flashcards

Flashcards in Ganglionic Cysts Deck (13)
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1
Q

What are ganglionic cysts?

A

Non-cancerous soft tissue lumps that occur along any joint or tendon.

Arise from degen within joint capsule or tendon sheath.

They then become filled with synovial fluid.

2
Q

Where are ganglionic cysts most commonly found?

A

Around hands and feet with 60-70% of ganglions appearing on the dorsal aspect of the wrist

3
Q

Epidemiology

A

More common in women

20-40 yo

4
Q

Risk factors

A

Female

OA -> increase of fluid in joint -> leakage to tendon sheath into cyst

Previous joint or tendon injury

5
Q

Clinical features

A

Smooth spherical painless lump adjacent to the affected joint

Can come on suddenly or insidiously grow.

The cyst can even disappear and reappear

6
Q

Examination findings

A

Soft + transilluminate

Can mechanically restrict full range of motion

7
Q

Additional symptoms that can occur

A

The cyst can put pressure on adjacent nerve and produce associated symptoms of nerve compression

8
Q

Dx

A

Tenosynovitis

Giant cell tumour of tendon sheath (does not transilluminate and is fixed)

Lipoma (does not transilluminate)

OA (hard mass)

Sarcoma (not well circumscribed or mobile)

9
Q

Ix

A

Diagnosed clinically

X-ray can be done to rule out OA, malignancy or any other differentials

USS or MRI can be done to assess shape, size and depth if there is uncertainty

Aspiration can be done for temporary symptomatic relief and fluid sent for microscopy and cytology if indicated

10
Q

X-ray findings

A

Ganglions cannot be seen on x-ray

11
Q

Management

A

Usually only monitoring is done as they disappear spontaneously most commonly

12
Q

Indications for further management

A

Pain or severely limits range of movement

13
Q

Further management

A

Aspiration +/- steroid injection (this can however cause infection and has a high rate of recurrence)

Cyst excision to remove the cyst capsule + a part of the associated tendon sheath (this has a lower recurrence rate) and is usually only done if there is recurrence following aspiration.