Ganglion : Clinical Features

Comments:
Sites: Ganglion occurs around joints and tendon sheaths. The most common location is dorsal surface of the wrist. It accounts for 50-70% of all masses arising in the hands or wrist. Less common sites include volar surface of wrist (superficial and medial to the radial artery) or volar surface of fingers (just distal to the metacarpophalangeal joint), dorsum of foot and toes, around ankle and knee joints, and ligaments of spine. The lesions are located in superficial soft tissue, between tendon planes. In rare cases, the lesion erodes into the adjacent bone and can become totally intraosseous.

Clinical Presentation: Ganglion usually occurs in young patients (25-45 yr. age group) with a strong female predilection. The risk factors are repetitive motion around wrist and overuse of fingers in certain professions (e.g. pianists, typists/computer users). There is history of trauma in 50% of cases. It can cause tenderness, mild pain, weakness and limitation of movement.

The image shows a surgically resected ganglion. Image courtesy of: Dr. Ibrahim Zardawi; used with permission.