Ganglion CystsDz

ICD-9 Code: 727.40.
ICD-10: M67.4

Definition: Ganglions are cystic masses that arise in proximity to joint capsules or tendon sheaths but do not communicate with the joint cavity. They are most common with repetitive strain or overuse, trauma, or inflammatory arthritis.

Pathology: Ganglia are formed by a dense capsule of mesenchymal connective tissue that encloses one or more cavities. These cavities are thin walled and contain a viscous, mucinous fluid.

Cardinal Findings: Ganglia arise most commonly on the dorsal aspect of the wrist; however, they also occur on the volar aspect of the wrist, the medial and lateral aspects of the knee, the dorsum of the foot, and the anterior aspect of the lower leg. Although most ganglia are asymptomatic, symptoms may relate to their location and impingement on adjacent structures (e.g., restriction of motion, paresthesias). They may become painful if traumatized. Recently formed ganglia are easily compressible; with chronicity, they may become more indurated and nodule-like.

Therapy: Patients with ganglia may seek medical therapy for symptoms related to tendinous, neural, or vascular impingement or for cosmetic reasons. Ganglia may resolve spontaneously and recur over time. Treatment varies according to duration and symptoms. Ganglia of only a few months’ duration may be treated by firm compression. This can be accomplished with a firm object such as a padded coin secured by an elastic bandage for several weeks. Alternatively, the mucinous fluid can be removed with a large-bore needle. Corticosteroid injection may also be used. Chronic or recurrent ganglionic cysts may require excision.

BIBLIOGRAPHY

Soren A. Clinical and pathologic characteristics and treatment of ganglia. Contemp Orthop 1995;31:34–38.