Ganglion

 

Definition

 

Cystic structure lined by a mature capsule of dense fibrous tissue

- contains thick viscous fluid with a high mucopolysaccharide content

- fluid is a myxoid degeneration of synovial fluid

 

Epidemiology

 

Most common in young females

- peak age 15-30

- F:M = 3:1

 

Location

 

Most common hand

Foot

 

Knee- cruciate ligaments, meniscus 

 

Etiology

 

Unclear

 

Numerous theories

- synovial herniation through capsular defect with development one way valve

- synovial rest

 

History

 

Lump

- appears suddenly or develop slowly

- subside with rest & enlarge with activity

 

MRI

 

Ganglion 3Ganglionganglion 2

 

Histology 

 

Wall of fibrous connective tissue

- no true epithelial or synovial lining

- contents consist of hyaluronic acid / plasma proteins

 

Management 

 

- Boneschool page: Hand Ganglion

- Boneschool page: Foot Ganglion

 

Options

 

Aspiration of cyst + injection cortisone

 

Excision

 

Ankle ganglionFoot Ganglion Excision