Associated symptoms
Depending on where the bump is located and what the actual cause is, various accompanying symptoms can occur. If the bruise is located on the inside of the wrist, bending of the hand towards the forearm may be limited, as the flexor tendons could be blocked by the spatial demands of the bruise. Furthermore, a bunion of the fist may not be completely possible.
The bending of individual fingers may also be limited. If the bump lies in the palm of the hand and reaches deep into the tissue, nerves may be irritated depending on the topographical position. The median and ulnar nerves can be particularly affected.
This can lead to symptoms similar to carpal tunnel syndrome with restrictions of the median nerve – tingling and numbness in the palm of the hand, as well as insufficient flexion of the thumb, index and middle finger. Symptoms of irritation of the ulnar nerve can be felt as tingling and numbness on the side of the little finger, as in the case of the Loge de Guyon syndrome. If the bump is on the back of the hand, the extension of the whole hand or of individual fingers may be limited. Here, too, a tingling or sensation of discomfort can occur, extending to the fingertips or elbows.
Pain
In many cases a bump can be painless, but often the skin feels tight. If pain occurs, the intensity, radiance and character of the pain can vary greatly. The character of the pain can vary from a dull dull to a sharp sharp pain.
Furthermore, it can be motion-dependent or permanent. If it is a ganglion, it can often remain painless. Pain usually occurs when tendons are pinched due to the space requirement or nerves are irritated by the increasing tissue.
Diagnosis
The diagnosis is backed up by a multi-stage process. First, a suspected diagnosis is made on the basis of the medical history. The time of the occurrence of the bump, pain and other symptoms such as sensation or movement restrictions can indicate a diagnosis.
If there is a suspicion of what the bump might be, further tests are performed to confirm the diagnosis. There are, for example, options such as sonography with an ultrasound probe, Doppler sonography or puncture of the lump. Especially if a ganglion is suspected on the palm of the hand, the Doppler sonography is used to see whether vessels or tendons are also affected. Other imaging procedures such as MRT (magnetic resonance imaging) or CT (computed tomography) can also be used in special cases.
Treatment and therapy
If the bump swells up, hurts to the touch and changes colour like a bruise, you can also use a cool pack to help. If a ganglion has been diagnostically confirmed by sonography, for example, it does not necessarily have to be treated. As long as it does not cause any discomfort or is aesthetically disturbing, a ganglion can be left untreated.
However, if symptoms occur, there are several possibilities. Firstly, the ganglion can be punctured and the fluid aspirated. Afterwards, cortisone is often injected into the cyst cavity in an attempt to prevent a new filling with joint fluid.
On the other hand, the ganglion can be resected in a small operation with local anesthesia. A further option is the arthroscopic removal of the ganglion, which is mainly used for ganglions on the back of the hand. Since ganglions are very recurrent, a further operation after the first one may well be possible.
Under no circumstances should a ganglion itself be treated! If the bump is a fracture, the further procedure is decided depending on the type and location of the fracture. The treatment can vary, from surgery to conservative therapy with a plaster splint.
