We define the synovial cyst, also known as ganglion, as a defined rounded mass located near an articulation. They are round or oval benign tumors and there is inside a jellylike mucoid liquid. They are usually asymptomatic and have a variable size, they can be bigger with time by the movement of the adjacent articulation.
The patients may have pain, feeling, debility (exacerbated with movement) and inconvenience in an aesthetic way. The symptomatology appears when the ganglion puts pressure on a bordering nerve or other structures, showing in this way numbness, a tingling sensation, pain or muscular debility.
Although the etiology of the appearance of the synovial cyst it is unknown, it is believed that it comes up of repetitive micro-traumatisms that give rise to a mucinous degeneration of the connective tissue which comes up of the coating of a tendon or an articulation. This takes place because such repetitive lesions in the capsular and ligamentous structures of support seem to stimulate the fibroblasts in order to make hyaluronic acid, which is accumulated to make the “gelatinous” material of the mentioned mucin.
The ganglionic cysts represent between 60% and 70% of the masses of soft tissues which are in the hand and the wrist, we also locate them on knees and feet. Although they can be formed at any age, they frequently appear in women from 20 to 50 years old. Women have three times more probabilities of developing a ganglionic cyst than men. These cysts also frequently appear among gymnasts, probably secondary to repetitive traumatisms and stress of the wrist articulation.
Among the possible risk factors, we have to emphasize its effect in people with osteoarthritis by exhaustion on articulations above all, of toes, as well as articulations or tendons which have had a lesion.
The ultrasound scans, magnetic resonances or radiography, help us to confirm the diagnosis and also to rule out other pathologies of similar features.
As we have said before, the synovial cysts don’t use to need treatment, in fact they can go down spontaneously, but in the case that the size, pain or another symptomatology have increased, a conservative treatment will be initiated, that is to say, the immobilization through splints or plaster of the articulation of a certain duration will reduce the ganglion. If this doesn’t work, we will carry out an invasive treatment, draining the contents of the inside cyst through puncture. There are recidivations in some cases.
Therefore, the surgical split of the synovial cyst is usually the chosen treatment, but for this, it is very important to know deeply the underlying anatomy in order to avoid injuring the neurovascular structures next to the cyst. There is no treatment to guarantee that the cyst will not appear again.
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