What is a Ganglion and How to Treat It
A ganglion is a collection (also called a cyst) of jelly-like fluid in a thinned out portion of synovium of a joint. This is a result of trauma or repeated minor injuries. It is often found on the back of wrists or the dorsum of ankles.
It is at times painful or tender. It sometimes goes away spontaneously without treatment. But then it often comes back after a few weeks. This is related to the cyst rupturing from trauma and recurring as the leak gets sealed in time.
How do we treat this?
Ganglions are best left alone if they don’t give rise to symptoms. If they are symptomatic. They are treated with aspiration or surgical removal. Aspiration, once popular years ago, carries a recurrence rate of over 90% (almost a certainty) and is not recommended these days. Some doctors combine aspiration with injection of steroid into the cyst with aspiration to reduce the recurrence rate. Nevertheless, the efficacy of this is far from proven. Surgical removal carries a recurrence rate of 20%. There is more recovery to do, in terms of joint stiffness to overcome after surgery. Besides, the patient must learn about the possibility of recurrence before they consent for surgery. Patients must realize that over 90% of ganglions are managed by non-treatment as they are more a bother than a threat to health.
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