Diagnosis | Ganglion on the wrist

Diagnosis

The diagnosis of a ganglion on the wrist is usually visible at first glance. The location and form of the swelling alone can lead to the suspected diagnosis of a ganglion during a physical examination. In addition, it can be tested whether the skin above the ganglion is movable.

The diagnosis can be confirmed by a laboratory examination of the fluid from the ganglion. For this purpose, the ganglion is punctured and fluid is withdrawn through a needle. Ultrasound is used in particular to prove that the ganglion is filled with fluid.

Only rarely is it possible to visualize the stalk. In principle, the diagnosis of the ganglion can also be established directly during surgery. In rare cases, an x-ray is taken of the affected finger to exclude a bony cause of the swelling.

Therapy

The most important component in the therapy of the ganglion on the wrist is the immobilization of the joint. This usually results in a reduction of the swelling, but the ganglion often reoccurs when the wrist is stressed again. When it recurs, the ganglion can be massaged, which forces the fluid back into the joint.

Occasionally, an attempt is also made to burst the ganglion. If the fluid cannot be pushed out, a ganglion puncture can be performed. In this procedure, the fluid is extracted from the ganglion using a syringe.

Surgical removal of the ganglion is usually only used when conservative therapeutic measures fail. Puncture of the ganglion is performed with a syringe and needle. The needle is used to puncture the ganglion at the wrist, and the fluid is then extracted.

In most cases, the puncture is performed to remove all the fluid for therapeutic purposes. However, the fluid can still be examined in the laboratory afterwards, so that the puncture also fulfils diagnostic purposes. It is hoped that a puncture will completely heal the ganglion, but it must be expected that every second punctured ganglion will return and require further treatment.

A ganglion on the wrist often develops at a tendon sheath and is triggered there by overloading. This overload leads to chronic irritation, which promotes the development of a ganglion. In the acute stage of the ganglion, it is not recommended to tap it, a splint is usually the more sensible therapy option.

However, the development of the ganglion on the wrist can be prevented by relieving the tendons and thus also the tendon sheaths by taping. A splint is used for immobilization, which is part of conservative therapy of the ganglion. Since the ganglion at the wrist is due to excessive stress on the joint, the ganglion should be treated with immobilization. A ganglion often recedes when a splint is worn, but recurrences, i.e. the ganglion reappears when the affected hand is used again, thus placing renewed stress on the wrist.