Ganglion Cyst Of The Wrist - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video describes ganglion cysts of the wrist.
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Ganglion cyst of the wrist
Ganglion cyst of the wrist is a very common hand mass. It is not a tumor. It is basically a cyst that is filled
with gelatinous fluid and it transilluminates. Transilluminate means that it transmits light through it.
What is a ganglion cyst?
Nobody really knows the exact cause of a ganglion cyst, but it seems that the cyst is filled with fluid, either
from the tendon sheath or from the joint. The ganglion cyst of the wrist can be either on the dorsal aspect
or the volar aspect of the wrist.
The dorsal type is common and it is not as bad as the volar type. It arises from the scapulolunate articulation as shown here. The volar type is not as common and it can compress the radial artery or compressing the nerve (median nerve and ulnar nerve). The volar cyst can be bad, compromising the circulation in the hand. Volar type arises from the radiocarpal joint, which is the wrist joint.
How does the ganglion cyst present itself?
Usually the ganglia itself does not cause any symptoms. It looks like a well-defined mass or a bump that is localized, smooth and not attached to the skin. If it is in the dorsal aspect, it becomes very obvious when you flex the wrist. If it is a volar ganglia, it becomes obvious when you extend the wrist. The patient is more concerned about the look and the cosmesis. When you examine the patient, you want to make sure that the volar ganglia does not affect the circulation of the hand, so we do something called the "Allen's test ". The Allen's test will evaluate the flow of the circulation in the radial and ulnar arteries. The MRI is not routinely done, but if it is done for whatever reason, then there is usually a fluid signal within the mass. Ultrasound is a good study to see the relationship between the volar cyst in the artery. Ultrasound is also good when you try to aspirate the ganglion cyst that is near the artery. It is not a tumor, so we do not do a biopsy.
Treatment
• Usually observation
• Aspiration (in some cases)
o Put the needle in and aspirate the fluid
o Try to avoid aspiration of the ganglion cyst in the volar aspect because it is near the artery.
o If you want to do aspiration of the volar ganglion cyst then you need to have the wrist hyperextended (try to see the artery and displace it away from the cyst) and use an ultrasound to guide you in aspiration of the cyst.
o Aspiration is usually done for the dorsal ganglion cyst (high recurrence rate of about 50%)
o There is not much of a risk and aspiration of the dorsal ganglion cyst
• Surgery
o Done for severe symptoms and if the ganglion cyst is painful or if there is neurovascular compromise.
o When you excise the cyst, you resect the capsule and the stalk (tract the root and excised the root of the cyst)
o The cyst comes back in about 10% if it is in the dorsal aspect
o Recurrence rate is about 20% if it occurs in the volar aspect
o It is imperative to do the Allen's test to check the blood flow before you excise the volar ganglion cyst

[@Joe-nj3bb]

Had my volar cyst aspirated last week.

[@sm8770]

i hv volar....inside d wrist.. and it pains...i cant work on computers without tieing anything around it... after small operation it got removed....but in few days new one showd up....its also painful..wat to do..any idea

[@frankbush8368]

Mine is more on the side (inside of wrist) than directly on top or underneath. Sometimes when present, it is invisible and pressing on the nerves causing much pain. It manifests deeper within the joint. When its visibly bulging, it is not pressing on nerves and is just a cosmetic complaint on the surface. It alternates between these two different manifestations at random. When its more interior it is excruciating. That would be today. Hard to sleep and all consuming pain.

[@ruthcudjoe6275]

This video has been very helpful.Thank you

[@healthtips6848]

Thanks from Pakistan🇵🇰

[@BendyGamer-fj9zh]

Mine hurts so bad i cannot grab things or move my wrist. Anything with even just a small amount of weight hurts. Pain shoots up my fingers.

[@icegirl152]

Thank you, this was very helpful.

[@nishalasanthi3457]

Thanks sir

[@TK-oi3jy]

I've been looking for info about my ganglion on the back of my hand past the wrist going towards the 2nd and third finger it's causing pain and cannot bring my hand back with major pain the my second finger little finger can move well no pain I've looked for vids like mine but there in different areas I've had it drained but it filled up by that evening when they drained it i could open my completely without pain I want to know what's going on please

[@sumanth.gsogal]

Tq for the video i do have one and will consult Dr tomorrow ❤️

[@adambit1470]

Sir please make video on TFCC tears and management

[@padmavathykunapareddy712]

Very nice explanation ..we can easily understand the problem..👌

[@onlineeducation3673]

Respected sir your all videos are informative and awesome. thete is 10×6mm hypoechoic lesion below subcutaneous plane at level of proximal intercarpal joint on dorsal aspect of wrist from last six month after injury.may be malignant tumor?is there requirements of mri? .Hoping to be favoured.thanks

[@gamaltaher9714]

Thanks

[@a2motivationtwoline385]

सब लोग भगवान से प्रार्थना करना हमारे शहीदो जवान कि आत्मा को शांति देना आपको तिरंगे की कसम 🇮🇳🇮🇳👌🏻🙏

[@sonubharti2911]

Sir kisi patient ko dikha ho toh wah kaise dikhaega aapase

[@IamPhysio]

Thankyou for sharing knowledge

[@wenrulee7191]

Thank you

[@csikosjutkaveresne]

Köszönöm szépen... 😘

[@DJSHANTlLAL]

Nice