Hygroma (from lat. Hygros – fluid, oma – tumor) – benign neoplasms resembling soft or condensed cysts. Histologically, they have a thin connective tissue capsule and contain mucous material filled with serous gelatin fluid rich in hyaluronic acid and other mucopolysaccharides.
Cystic formations are round or oval, their size is about 0,5-3 cm in diameter. On palpation, they can feel like small lumps under the skin, but visually remain invisible. Larger cysts reach a diameter of 4-5 cm.
Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.
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Causes of appearance
The exact cause of the appearance of ganglion cysts is unknown. It is believed that they arise as a result of excessive physical exertion, squeezing or injuries. Mechanical action causes joint tissue to collapse, forming small cysts, which then combine into a large, formed mass. There are frequent cases of their “sudden” appearance due to heredity. Basically, the pathology affects people aged 20 to 40 years, and women are more susceptible than men. Rarely, seals occur in children under 10 years of age.
Ganglion cysts are not malignant, therefore they do not pose a serious medical threat. They appear suddenly, although they can develop for a long time. Additional symptoms:
- neuralgic pain due to mechanical action on the affected joint or tendon (if the growing tumor presses on nearby nerves);
- if pain is present, it is chronic and intensifies when exposed to a bump;
- tingling, numbness and muscle weakness in the area of localization of education;
- venous congestion;
- an increase in the size of the cyst with active physical activity and a decrease in its size at rest.
Some ganglia remain painless, although they continue to grow slowly. The skin over the formation can become thicker, inflame, peel off and acquire a bluish color.
Varieties of hygrom
In medical practice, two types of ganglion cysts are distinguished – single and multi-chamber. Single chamber formations are inelastic, therefore, cannot expand. Multi-chamber, on the contrary, have lateral branches, therefore, they spread deep into the tissues.
Depending on the location, hygroma is distinguished:
- upper limbs: hands, fingers, wrist and elbow joints;
- lower limbs: foot, ankle and knee joints;
- shoulder joint;
- in the neck;
- on the head.
On the wrist, hand and fingers
Such formations are the most common among others. They grow either from the synovial vagina, or from the joints themselves. In the first case, all cystic formations are small and retain mobility. Joint tumors are quite dense and motionless, can grow in all directions relative to the capsule, due to which they acquire quite large forms.
If a painful bump appears on the joint of a finger, this may indicate the presence of joint diseases – arthritis, arthrosis, gout. The reasons for their appearance are metabolic disturbance, hormonal failure. Such formations rarely go unnoticed, because they cause severe discomfort, interfere with work, and cause inconvenience in everyday life.
On the knee joint
Pathology is the result of certain diseases (arthrosis, arthritis, knee wear, intraarticular hematomas) and injuries. In 80% of cases, a bump on the knee joint appears in men and women whose activity is associated with excessive physical exertion. In adolescence, it may appear during puberty. The tumor is localized in the popliteal region, less often in the lateral regions and almost never on the outer surface.
In the early stages, the disease proceeds unnoticed, causing only unpleasant stitching sensations with pressure. When the hygroma reaches 8-10 cm in diameter, it becomes an obstacle to full bending of the leg, and violent attempts to make a movement lead to weakness in the limb and pain in the knee.
On the ankle
The ankle joint is a rather complex structure, regularly subjected to heavy loads. The appearance of a hygroma in this area is usually associated with gross injuries – ruptures and sprains of tendons, dislocations. Inflammation in the ankle joint can also affect their manifestation. Women wearing high-heeled shoes are at risk due to the unevenly distributed load on the foot.
The bump on the ankle joint can reach large sizes, about 5 cm in diameter. With slow growth, the tumor forms within a few months, sometimes years. Rapid growth leads to the fact that the hygroma reaches critical sizes in a few days or weeks, causing a person serious discomfort. In this case, surgical treatment is prescribed that relieves the patient of pain in the ankle and stops tissue proliferation.
Hygroma in the foot area is localized in its front part (metatarsus and toes) on the back surface. Such formations do not cause pain, although they are inconvenient when walking and wearing tight shoes. The presence of pain in the foot indicates that the tumor presses on the nerve endings and blood vessels located next to it.
On the shoulder joint
The most mobile area of the musculoskeletal system is the shoulder. And this zone, like the ankle, is daily subjected to physical exertion, which leads to bone deformation and vascular compression. All this contributes to the formation of ganglion cysts. In addition to general symptoms, the appearance of a hygroma on the shoulder is accompanied by swelling when neighboring areas – the neck, shoulder, and forearm swell.
Very often, a lump on the shoulder joint is mistaken for a purulent inflammatory disease of the periarticular bag – bursitis. They have similar symptoms, but these are two different diseases.
It is a narrow-profile specialist – a traumatologist, surgeon or orthopedist, who must diagnose the pathology and choose the path to eliminate it. This will prevent further tumor growth and protect the patient from the consequences caused by untimely or incorrect treatment!
On the neck
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Cervical hygroma occurs in the back of the neck. The reason for its appearance is the non-fusion of the lymphatic vessels, which leads to their expansion and the formation of seals. The clinical picture is not always unambiguous: in some cases, the tumor does not cause pain in the cervical spine, but only grows slowly; in others, it causes severe discomfort. There are “group” formations, when several cones appear on the neck at once, which “wrap” the entire cervical spine.
To establish an accurate diagnosis, examination of the bump on the joint is not enough. A more thorough examination is required using additional instrumental research methods:
- Roentgenography. This method eliminates bone pathology.
- Ultrasound (ultrasound). Helps determine the exact location of the tumor, its reliefs and density, nature and consistency of its contents.
- Magnetic resonance imaging (MRI). It is used to determine all parameters of the tumor, including the presence of an inflammatory process. This diagnostic method is the most accurate, but also the most expensive.
- Puncture. The procedure involves puncture of the tumor and sampling its contents for histological examination.
X-ray and ultrasound are often enough to confirm the diagnosis. However, if more serious disorders, such as malignant tumors, are suspected, a full examination with MRI and histology is mandatory.
Joint bump treatment
More recently, crushing was used to remove tendon ganglia. He suggested mechanical compression of the cone, as a result of which the cyst burst, and its contents spread over the adjacent tissues. The procedure is very painful, and the patient’s torment was absolutely useless, since relapse occurred in 100% of cases. Therefore, today this method of therapy is practically not used. There are two main methods for treating articular cones:
- Conservative. It implies the use of drugs, physiotherapy aimed at eliminating pain and swelling – ultraviolet radiation, mud and paraffin compresses, electrophoresis, phonophoresis. This also includes immobilization (using an orthosis) to limit the mobility of the joint, which allows the cyst to decrease in size.
- Prompt. Surgical treatment is prescribed only by a doctor if the tumor has reached a large size, brings physical inconvenience, pain, limitation of mobility of the musculoskeletal system. The number of tendon ganglia is from 1 to several pieces.
It is aimed at eliminating the pain syndrome, relieving inflammation, restoring metabolic processes in the tissues of the joints:
- with severe pain syndrome, which is accompanied by swelling of the periarticular tissues, reddening of the skin, and an increase in temperature in the tumor localization zone, non-stero />
Before taking medications, you should consult your doctor. If the appearance of a hygroma is associated with other diseases of the musculoskeletal system, then treatment with the described medications will be ineffective.
When conservative treatment does not give a noticeable improvement or the cyst grows again, they use a more radical method of struggle – operable excision. Indications for the operation:
- pain syndrome provoked by the pressure of the tumor on the nerve endings and vascular walls;
- limited movement of the affected joint;
- inflammatory process in the joint cone;
- relapses of hygroma.
Surgeons apply local anesthesia and remove the tumor. General anesthesia is indicated if the tumor is located in an inaccessible place or if the patient is over 55 years old. The procedure is usually performed on an outpatient basis and is performed in several ways:
- aspiration. It involves placing a needle in a tumor, extracting liquid material, administering a steroid (anti-inflammatory) drug, and then splinting a limb to completely immobilize. The fluid inside the cyst is similar to that naturally produced in the joints. Therefore, its removal is equivalent to the removal of the cyst itself. However, it must be understood that if its “root” is not destroyed, the risk of relapse is very high;
- open surgery. Through a small incision, the hygroma is removed along with the leg, which minimizes the risk of its reappearance;
- laparoscopy. Minimally invasive surgery using a laparoscope. Intervention is less painful than open surgery, does not require a long recovery;
- laser soldering. During the operation, the doctor uses a carbon dioxide laser, with the help of which the skin is dissected. The capsule with serous fluid is promptly removed, then the incision made by the laser is carefully sutured. The operation takes up to half an hour, performed under local or general anesthesia. This method is preferably used if the hygroma is located in the wrist area.
Traditional methods of treatment
Alternative medicine can also have a positive effect on the resulting bumps in the joints. However, they are allowed to be used only by agreement with the doctor, when the patient is fully examined and the malignant nature of the tumor is excluded.
Clay compress. It is used to relieve inflammation, heat and resorption of the tumor. Used until the bump is reduced.
- Mix to the consistency of tortillas 50 g of clay, 1 tbsp. l sea salt, 200 ml of boiling water and 7 drops of turpentine.
- The finished composition is applied to the cone area for 15-20 minutes, wrapping with a towel.
Baths with salt. Such procedures are recommended to be performed when a lump has formed on the foot or hands. If the disease is not started, the formation resolves quickly. Long-standing hygromas require long-term treatment.
- Dissolve 5 g of salt (kitchen or sea) in 200 l of hot water.
- Pour water into a basin and immerse a limb with a cone in it.
- Hold for 15 minutes.
You can also mix salt with snow, apply such a compress to the hygroma for 5 minutes. Overexposure is not worth it, as you can get a burn.
Compresses with medical bile. It has a resolving effect, eliminates salt deposits, has anti-inflammatory and anesthetic effects. It must be applied daily until the cones disappear completely.
- Treat hygroma with iodine solution.
- Apply medical bile to the tumor (you can use beef or chicken), cover with oilcloth, fix with a gauze or cloth dressing and wrap it with a down scarf.
- Hold for 2 hours, repeat three times a day.
Egg ointment. It is recommended to use the product every other day for a month. During this time, the tumor should dissolve.
- Dissolve 200 egg in 7 ml of 1% vinegar essence.
- Leave in a dark place for 2 weeks.
- In the egg mixture, add 1 tbsp. l pork fat and 10 g of turpentine.
Potato broth for baths. Good remedy for joint cysts. After 2 weeks of regular use, the result is noticeable – the cones are reduced in size.
- Peel 4-5 potato tubers and put them in a pan.
- Pour 3 liters of water and simmer on the fire for 15 minutes.
- Pour the prepared broth into the basin in order to soar the feet or hands in it for 30 minutes.
Boiled cleanings can be used for medicinal purposes. They need to cool a little and apply to the cones for half an hour, wrapping a towel.
An effective approach to the treatment of tendon ganglia requires a comprehensive approach, therefore, in addition to taking medications, patients are recommended sparing physical activity for the hands, ankle, knee and shoulder joints. Daily exercise therapy helps increase blood flow, restore joint tissue and increase joint mobility. The main exercises of the complex:
- squeezing and unclenching of the hands, toes;
- circular movements of all joints;
- their flexion and extension.
It is impossible to prevent the development of joint hygroma, however, the risk of its occurrence can be minimized. To do this, follow the recommendations of doctors:
- avoid injuries of the musculoskeletal system, and upon receipt of them urgently seek medical help;
- timely treat chronic diseases of ODA;
- Do not abuse the load, observe the regime of physical activity and rest necessary to restore the muscular system;
- wear only comfortable shoes;
- use fixing bandages, elastic bandages;
- adhere to the rules of a healthy diet: consume protein, calcium, phosphorus, vitamins every day.
Compliance with these rules will provide long-term health, flexibility and free movement of the joints. React in time for any changes in your body, as even tiny neoplasms can be harbingers of serious illness!