Hygroma of the wrist joint.

One of the most common neoplasms that is localized in the area of the human hand is the hygroma of the wrist joint (or its second name is ganglion).

A hygroma is a round tissue formation that forms in the wrist joint. The hygroma capsule is filled with high-molecular proteins such as fibrin and mucin. In essence, a wrist hygroma is a cyst, not a tumor.

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Causes of wrist hygroma

No doctor can clearly specify the etiology of this disease today. However, the risk group includes people who are engaged in heavy physical labor or whose work is associated with increased motor activity of the hand (musicians, computer users, seamstresses and other professions).

Main Causes of Wrist Hygroma:

• Heavy physical labor, the load of which falls on the hands, and in particular, on the wrist joint.
• Complication following surgery performed on the hand.
• A complication following tendovaginitis (inflammation of the tendon sheath) or bursitis (inflammation of the mucous sac of the joint).
• Consequence of injury.
• Degenerative-dystrophic disease of the joints.
• Recurring microtraumas (for example, when playing tennis...).
• Chronic nature of inflammation of the synovial cavities.

The pathology in question is formed when, for some reason, the joint capsule becomes thinner and then damaged, which allows the internal tissue to be squeezed out into the resulting gap, forming a hernia. If the load remains significant, the hygroma continues to grow. Its size varies from several millimeters to four centimeters. When the applied load decreases, the amount of intra-articular fluid produced decreases, and the neoplasm stops growing. There have been cases where, when the load on the joint decreases, the wrist hygroma spontaneously “dissolved”.

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Symptoms of wrist hygroma

Symptoms of a wrist hygroma are quite simple. Initially, the pathology is detected by the appearance of a small bulge in the wrist area, which is easily palpated. Their content is palpated as elastically soft. At the same time, a person does not experience any unpleasant sensations. At this stage, the hygroma can be for up to several years.

It appears suddenly and can literally gain two centimeters in size in a couple of days, and can grow unnoticed for many years. As the size increases, painful sensations arise, which intensify when moving the hand.

But it is important to know that this neoplasm is safe and under no circumstances will it degenerate into a cancerous tumor.

Treatment of hygroma of the wrist joint

Often, a simple medical examination is enough to diagnose the pathology. To be on the safe side, the orthopedic surgeon may prescribe various diagnostics (ultrasound or magnetic resonance imaging) to the patient.

Treatment of hygroma of the wrist joint can be conservative or can involve surgical intervention.

Conservative treatment of wrist hygroma

Until recently, this was practically the only way to get rid of a wrist hygroma. A certain amount of force was applied to the neoplasm and it was simply crushed. In this case, the "capsule ruptured", releasing its contents into the adjacent tissue layers. The internal synovial fluid is sterile, therefore, when it gets into the tissue space, it does not cause the development of inflammatory processes.

But, as monitoring and clinical studies of this problem show, relapses are observed in almost 90% of cases of conservative treatment of hygroma of the wrist joint. This is due to the fact that the ruptured capsule quickly restores its integrity and the intra-articular fluid begins to accumulate again.

With a decrease in tension and load on the hand, 50% of wrist hygromas quietly resolve on their own.

There is another method of conservative treatment - glucocorticoid blockade. This procedure is quite effective in combating the pathology in question, but only in the early stages of its appearance, when its parameters do not exceed one centimeter.

The essence of the method is that the location of the neoplasm is anesthetized. Using a surgical instrument, the hygroma is punctured and the contents of the capsule are removed using a syringe. Then, without touching the needle, the syringes are replaced. A glucocorticoid drug (such as methylprednisolone, betamethasone, dexamethasone, and others) is injected into the empty hygroma sac of the wrist joint.

After this, a tight bandage is applied to the surgical site and worn for approximately five days. This time is enough for the capsule to “stick together” and its edges to grow together.

If the patient ignores the pressure bandage, then the mobility of the joint will again provoke an increase in the amount of fluid released, which will inevitably lead to a relapse of the wrist hygroma.

Methylprednisolone. The dosage of the drug required for the procedure is from 0.25 to 0.5 mg, depending on the size of the neoplasm.

This drug is contraindicated for people who are sensitive to its components, and methylprednisolone is not prescribed to children under 12 years of age. With a single local administration of the drug, side effects are practically not observed.

Betamethasone. This drug belongs to the strong group of action. Betamethasone is administered in an amount of 0.25 to 0.5 mg. After which a tightening bandage is applied.

This drug has a wider range of contraindications, while, due to the local application, no side effects are observed.

• Persistently high blood pressure readings.
• Acute form of tuberculosis.
• Problems with blood circulation.
• Diabetes mellitus.
• Glaucoma (increased intraocular pressure).
• Syphilis.
• Osteoporosis.
• Ulcer of the duodenum and stomach.
• First trimester of pregnancy.
• And others.

Dexamethasone. The dosage regimen is individual for each patient. The amount of liquid administered varies from 1 to 1.5 mg.

Conservative therapy also includes the following measures:

• Iodine electrophoresis.
• Paraffin or mud applications to the affected area.
• Exposure to ultraviolet rays.

If a wrist ganglion cyst is diagnosed to be larger than one centimeter and its structure is palpated as a group of several capsules, then, in most cases, this is an indication for surgical intervention (especially if it bothers the patient).

There are also folk methods of treatment, but they are practiced only for small-sized formations. The course of treatment, in this case, is at least ten days.

• Crush the wormwood leaves in a mortar and apply this mass as a compress to the hygroma of the wrist joint overnight.
• For two weeks, practice warm baths with a tincture made from lilac flowers.
• Honey is applied to the affected area and rubbed into the skin for several minutes, while the fingers massage the problem area.
• Grind the physalis berries in a meat grinder. Use as a compress at night.
• Knead the dough with aloe juice. Apply it to the formation.
• You can smear the “cyst” with iodine or pharmaceutical calendula tincture.
• Apply aloe or Kalanchoe leaves to the hygroma, securing it with film and a bandage.

There is no doubt that folk medicine in the case of treating hygroma of the wrist joint is harmless and quite positive, but depending on the size and type of pathology, its effectiveness is in many ways inferior to therapeutic methods, and especially to surgical intervention. Therefore, before deciding to use folk remedies, it is still worth consulting a specialist.

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Removal of hygroma of the wrist joint

An operation is always an operation. And if there is a possibility to avoid it, it is necessary to use it. Removal of a hygroma of the wrist joint is prescribed only in the case when the pathology interferes with the normal functioning of a person's hand, if during palpation not one but a group of capsules under one shell is felt, or if the patient insists on aesthetic discomfort.

The surgical intervention is performed on an outpatient basis under local or conduction anesthesia. After the capsule is removed, a tight bandage is applied to the patient's wrist, which must be worn for five days without fail. If the patient does not comply with this condition, the risk of recurrent development of wrist hygroma increases by several orders of magnitude.

Modern medicine is ready to offer a more gentle method of getting rid of the problem – laser removal. This procedure is not much different from the classic operation. Many patients are mistaken in believing that this method allows you to get rid of hygroma without cutting the skin and the subsequent scar.

The laser also dissects the epidermis and subcutaneous layer, exposing the neoplasm. It is carefully separated from the adjacent tissues and excised. The incision is small, the scar is small and slightly noticeable. After the operation, a fixing bandage is applied to the wrist joint, and the joint itself is fixed with an orthosis. The bandage is changed daily, treating the postoperative wound. The stitches are removed after 12-14 days.

The result of any operation largely depends on the surgeon who performs it: his experience and knowledge. It is impossible to say for sure which method gives more relapses. The recurrence of hygroma of the wrist joint is mostly associated with the competence of the doctor, the accuracy of his recommendations and the individual characteristics of the patient's body.

Prevention of hygroma of the wrist joint

"God protects those who protect themselves!" This simple truth perfectly reflects the basic principle that is followed in the prevention of wrist hygroma.

• It is necessary to minimize, as far as possible, injuries to tendons and joints of industrial, sports and domestic nature.
• During training, it is essential to wear protection on your hands.
• Develop a schedule that alternates between work and rest.
• In case of injury, immediately contact an orthopedic traumatologist for consultation and assistance.
• Timely and complete treatment of infectious and inflammatory processes occurring in the area of interest.
• If the patient has a predisposition to tumor formations, one should consider changing the type or place of work.

Prognosis of wrist hygroma

If you contact a specialist in a timely manner, the prognosis for a wrist hygroma is positive, especially if the entire neoplasm was completely removed during therapy. If the patient strictly followed the doctor's recommendations after the operation, the probability of relapse is reduced to almost zero. With simple therapeutic treatment, relapses are still possible.

If you work long and hard or your work is associated with increased motor activity of the hand, then there is a high probability of getting such a pathology as a hygroma of the wrist joint. But this should not be a cause for panic. Hygroma is a benign tumor that never degenerates into cancerous formations. In most cases, even without undergoing treatment, people live with this problem for many, many years, but this does not mean that everything should be left to chance. Still, it is worth contacting a specialist and undergoing an examination.

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