Swelling on the Wrist.

The Giant
Image by Fr Antunes via Flickr

The man was very much worried.” A bone was growing over the wrist since a few months” was his complain. The swelling was nearly circular, painless, almost defined boarders, does not move in any direction, hard to feel, almost fixed in the depth and was very slowly growing in size. So, he thought it to be a bony growth and must be dangerous.

I examined the swelling. It sits over the wrist with the characteristics as described above. Frequently I encounter this sort of complain. Mostly ladies are affected. This is also a beauty concern for them. Though most commonly seen near the wrist, it is also seen over the back of hand, forearm and near the tendons. That was diagnosed to be a ganglion.

A ganglion forms because of degenerative changes in the tissue covering of a tendon or that of a joint called synovial capsule. This may be termed as pseudoganglion or ganglion. When originates from the tendon sheath it is called pseudoganglion and when comes from the joint capsule is called a ganglion. A thick gelatinous material is found enclosed in a capsule. Many times the capsule is thin and sometimes it is thick. Diagnosed is based on clinical findings. Sometimes an x-rays examination is ordered to eliminate a bony growth.

The ganglion or the pseudoganglion is pressed hard so that it bursts and that gives a dramatic cure evidenced by sudden disappearance of the swelling. If thick walled it may not burst under pressure. In that case a wide bore needle is inserted into it and the gelatinous material is aspirated. Sometimes about 1 ml. of steroid is injected to the cavity. These procedures cure majority of patients. Sometimes larger ones require surgery by removing as much of capsule as possible. Ganglion is notorious for its recurrence. But it is an innocent disease.

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