A ganglion is a cystic swelling commonly found near tendons or synovial joints, particularly in the wrist. It is characterized by painless, fluctuating swellings caused by cystic degeneration of the tendon sheath and synovial fluid leakage. Management options include observation for asymptomatic cases, excision with a notable recurrence rate, or aspiration combined with sclerosant injection.

2. Ganglion
By
Momen Ali Khan

3. Definition
Cystic swelling occurring in relation to
tendon, synovial joint

4. Common site
Wrist joint- 90%
Hand
Clinical feature
Painless swelling

5. Pathogenesis
Cystic degeneration of the tendon sheath.
Leakage of synovial fluid through joint capsule.
There are small islets of microspaces in synovial sheath
which often fuse together or one of them gets enlarged
toform ganglion.

6. Examination finding
Smooth
Tensely cystic
Fluctuating swelling
Transillumination
Free from skin
Less mobile when underlying structure contract

7. Differential diagnosis
Bursa
Protrusion of synovial cavity of arthritic joint
Lipoma.
Lymph cyst.
Sebaceous cyst.

8. Management
Asymptomatic ganglion is better left alone because of high
recurrence rate.
 Excision-Usually done under local anaesthesia
(lignocaine plain 2%).
Patient should be explained of high recurrence
rate (30%). After excision always it should be sent
for histopathology.
Firm crepe bandage application for 4 weeks is
better in these patients.
 Aspiration and sclerosant injection may be useful.

10. Thanx