Ganglion - Transom

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Ganglion - Transom
Ganglion - Transom
Video: Ganglion - Transom
Video: Базальные ганглии. Базальные ядра. Basal ganglia of the brain. 2023, February
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Ganglion (upper leg)

A ganglion is a slowly growing, spherical cyst that can often be seen or felt as a round induration under the skin. It starts in the shape of a stalk from a joint, tendon, tendon or nerve sheath or, more rarely, from a meniscus. A ganglion is surrounded by a sheath of connective tissue, filled with a gelatinous fluid and usually elastic. Ganglia can become larger or smaller over time. 50 percent of the ganglia regress on their own. They occur mainly on the hand, fingers, wrist or ankle or, more rarely, on the shoulder, knee or spine, for example. Most often, a ganglion forms on the outside of the wrist and is also called the transom in this area due to its shape and strength.A ganglion is a benign tumor and is only treated if it causes symptoms.

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  • How does a ganglion arise?
  • What are the symptoms?
  • How is the diagnosis made?
  • How is a ganglion treated?
  • Whom can I ask?
  • How are the costs going to be covered?

How does a ganglion arise?

A possible cause of a ganglion (also called a hygroma, mucoid cyst, or Bible cyst) can be a weak point, injury, wear and tear, or irritation of:

  • a joint capsule,
  • a tendon
  • a tendon or nerve sheath,
  • firm connective tissue,
  • a bursa or
  • be a meniscus.

It is controversial whether frequent, uniform movements can promote the formation of a ganglion. Eventually they can trigger or intensify pain and stimulate the growth of a ganglion.

Ganglia can rarely grow in bone tissue near the joint (intraosseous ganglia), the periosteum (periosteal) or in soft connective tissue. With osteoarthritis of the fingers, ganglia often occur in the area of ​​a finger joint or phalanx (mucoid cysts).

What are the symptoms?

Ganglia often bulge out from under the skin, especially during certain movements. Then they can be seen and felt as spherical, rubber-like or sometimes solid structures. If a ganglion does not develop near the skin or shifts towards the skin, it is often only discovered when symptoms occur. Incidental findings are also very common.

Most ganglia do not cause symptoms. However, they are often perceived as unaesthetic. Many sufferers also contact a doctor because they fear that the change could be a malignant tumor.

In some cases, ganglia can be uncomfortable or cause pain. They seldom limit the mobility of joints or lead to sensory disturbances, nerve pain and / or paralysis through pressure on nerves.

With mucoid cysts near the nail bed, nail formation can be disturbed. The affected nail is often grooved, and wounds in the area of ​​the nail bed can also occur.

How is the diagnosis made?

With a careful clinical and radiological examination, the doctor can distinguish a ganglion from a solid or malignant tumor. If a cyst-shaped change bulges under the skin, she / he feels the change. In addition, the doctor can illuminate the palpable change with light, as ganglia are filled with fluid and therefore translucent. An ultrasound examination can also be carried out.

If the examination results are unclear, ganglia in atypical locations, suspicious clinical signs or very large ganglia, the doctor will have a diagnosis carried out using magnetic resonance imaging (MRI) prior to therapy. The same applies to changes that are not visible or palpable from the outside. Osteolysis (breakdown of bone tissue - for example in the case of an intraosseous ganglion) can also be detected using MRI.

How is a ganglion treated?

A stabilizing bandage can be applied for a short period of time in the event of movement pain. Long-term fixation should not be used, as this can weaken the immobilized muscles.

For treatment, the doctor can aspirate the fluid from the ganglion with an injection needle. However, over 50 percent of the ganglia form again within a year after this procedure. If the success lasts long, a new suction can be performed if a ganglion recurs. This treatment can rarely lead to an infection or to an injury to a vessel or nerve.

Surgical removal of a ganglion is possible if suctioning off the cyst fluid is unsuccessful or if there is severe discomfort. This can be done through an incision in the skin or, in the case of ganglia that originate from joints, under certain circumstances arthroscopically (using the buttonhole technique). The recurrence rate (measure of the frequency of recurrence of a ganglion after treatment) is the same for both techniques. Complications are less common with arthroscopic surgery. Arthroscopic surgery is also superior in terms of aesthetic results and wound healing.

Note The treatment of intraosseous ganglia is more complex. Among other things, the cavity that remains after the removal of an intraosseous ganglion can be filled with bone tissue.

Complications rarely occur. These include:

  • unsightly scarring
  • Pain
  • Reduced strength
  • Restriction of movement
  • Joint or tendon injury
  • Injury to nerves or blood vessels
  • infection

Physiotherapy can be performed in the event of pain or restricted mobility after an operation.

Ten percent of the ganglia form again after surgical treatment.

Whom can I ask?

The family doctor can carry out an initial examination. Afterwards, she / he can issue referrals for further radiological diagnostics or to a specialist in orthopedics, hand surgery or surgery.

A clarification can also be carried out from the beginning by a specialist mentioned above in a doctor's practice or in an outpatient department.

How are the costs going to be covered?

All necessary and appropriate diagnostic and therapeutic measures are taken over by the health insurance carriers. Your doctor will generally settle accounts directly with your health insurance provider. With certain health insurance providers, however, you may have to pay a deductible (treatment contribution) (e.g. BVAEB, SVS, SVS, BVAEB). However, you can also use a doctor of your choice (ie doctor without a health insurance contract). For more information, see Costs and Deductibles.

For certain examinations (e.g. MRI), approval from the health insurance provider responsible (medical service - "chief physician") may be required, as well as for certain drug or non-drug treatments (e.g. physical therapy), in some cases only when the disease has reached a certain extent. For certain services (e.g. inpatient stays, aids and medical aids) - depending on the health insurance provider - patient co-payments are provided. Most health insurance providers provide for a permit, sometimes depending on the type of medical aid. The prescription fee has to be paid for medication on a “cash prescription”. For more information about the respective provisions, please contact your health insurance provider, for exampleon your social security website.

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