Ganglion cysts/Bible cysts/Bible bumps

Ganglion cysts/Bible cysts/Bible bumps are lumps (tumor or swelling) within the back of hand at wrist joint mainly occurs to joints or tendons. They look like cyst containing a thick ,sticky ,clear ,colorless jellylike substance. They used to be more prominent when the wrist is flexed forward. These cysts may feel form of spongy by depending on their's size.More common in female .Most prevalent  range between 20-40 years old rarely occurs children younger than 10 years. 

Causes 

unknown, trauma , "Herniation hypothesis", post traumatic degeneration of connective tissues, and inflammation, repeated mechanical stress, facet arthrosis , myxoid degeneration of peri -aticular fibrous tissues and liquefaction with chronic damage.

Symptoms

• usually appears as bump that changes size
• usually soft,1-3 cm in diameter ,dose not mobile
• swelling appear over time or suddenly ,smaller in size and may even go away . And comes back in another time
• some causes pain, and some are asymptomatic except their's appearance
• In case if there is pain it's chronic and pain evoked & become worse by joint motion.
• feeling sense of weakness in case of finger affection when cysts were connected to tendon .  

Diagnosis

Ganglion cysts are visible and palpable to touch.

Further conformation is done by needle aspiration or by using USG. It make sure whether the bump is cyst or the solid it also rule out whether the artery or blood vessels that may causes lump.MRI can be used .

Treatment 

Self- home care 

Topical plaster, heat & various poultices, bible therapy, these therapy not done for longer 

Medical therapy

Drawing fluid ,injecting steroids and then splinting wrist to keep it from mobile.

Surgery

Surgical removable of these cysts indicated in case when the masses painful ,impaired with hand functions, or if there is any numbness, tingling of hands or fingers 

Complications after surgery

Joints stiffness and scar formation., re-occurrence of cysts, 

Prognosis

Re-occurrence rate is more in aspirated cysts than surgical ones. In surgical case re-occurrence % is  (12%-42%). In case of untreated patient ,58% resolved spontaneously .