Hygroma of the wrist joint
, cyst, ganglion, synovial hernia are the names of a benign tumor that is localized above the wrist joint. Women get sick more often. In some cases, the formation resolves on its own, without treatment.
Hygroma of the wrist is a round capsule with dense walls, filled with a viscous liquid. Can be located on the outside or on the inside. Transformation into a malignant tumor does not occur. Treatment aims to eliminate the external defect.
Diagnostics
To make an accurate diagnosis, you should consult an orthopedic surgeon. Determining the causes of the disease and treatment methods involves conducting an examination: the doctor must determine the location of the tumor and its size. Of the laboratory tests, only a biopsy will be indicative.
Diagnosis is carried out using:
- MRI or ;
- Ultrasound;
- X-rays;
- If necessary, a puncture of the hygroma is taken.
Types of disease
The ganglion of the wrist joint of the hand can be classified:
- Mucosal hygroma - appears as a result of deforming arthrosis, as a result of compression, the growth of connective tissue is a protective reaction of the body;
- Post-traumatic hygroma of the left or right wrist - occurs as a result of damage to the joint;
- Tendon hygroma - develops under the influence of pathological changes in the tendon sheath, causes pain, and interferes with normal movement of the wrist.
Puffy-like structures on the dorsal surface of the wrist and hand (Fig. 1)
Ganglia (hygromy)
Ganglia (superior tendon bones) are the widest, plump-like structures of the hands. The stench is localized to the tendons and tendons of various parts of the body, approximately 2/3 of the carpal ganglia can be located on the dorsal surface; Cause the stench to be located above the ligamentum scapho-lunatum distally to the promenian cyst (Fig. 2). The ganglion is best visualized when the wrists are bent straight towards the hips. Since the ganglion is large in size, it can form a palisade structure. The anamnesis may reveal clues about the presence of lesions of varying sizes, for which, with superficial localization, a characteristic positive result of diaphonoscopy. If necessary, the diagnosis can be confirmed by additional aspiration, this manipulation is also important according to choice. With surgical treatment, the third person may develop a relapse; with conservative treatment, the solution may arise spontaneously.
Rheumatoid tenosynovitis of genital ulcers
If other symptoms of illness are present, it is not difficult to make a diagnosis of rheumatoid tenosynovitis. Prote synovitis, which is located under the morning routine, can be mistaken for the dorsal ganglion, as long as it has a similar localization (though the veins have a wide and flat shape). A ligament with the rosginac tendons can often be confirmed as an additional symptom of “folding of the fold” (Fig. 3). At the hour of maximum extension of the fingers, a fold appears at the distal end of the new creation, where the tendons of the spinach tendon are attached to the subsynovial tissue. There is always a need for histological confirmation of the early stage of the rheumatoid process.
Metacarpal hump
Metacarpal hump
- a small cystic hump (called the other or third carpometacarpal hump) - located further and closer to the promenal cyst, the classic localization is the ganglion. This pathology most often occurs after injury, although it can develop spontaneously. The appearance of this opening may be accompanied by a period of local discomfort, and the tendons of the fingers may “click” over it. Surgical treatment is performed only if severe pain or clicking is evident.
De Quervain syndrome - stenotic tenosynovitis
This pathology is manifested by pain and increased development of the first finger, as a result of which a spindle-like neoplasm often appears over the styloid process of the promenian cyst. Sometimes when you touch your thumb with your thumb, crepitation occurs. The bending of the first finger against the support provokes the appearance of pain, this provocative test is reliable, the lower Finkelstein test (the bending of the first finger along the palm and the deviation of the wrist at the direct ulnar bone; in this case, And the presence of wrist pathology often results in discomfort, which needs to be corrected results of the test on both sides). The Felkelstein test is not considered specific for de Quervain
, VIN is often positive in patients with osteoarthritis of the proximal tip of the first finger or in patients with non-healing of the hand.
De Quervain's syndrome
may occur after extreme physical exertion (due to direct degeneration of the promenian or ulnar fistula), 3 days after the splint is applied, the symptoms become clearer. It is often possible to achieve treatment with additional corticosteroid injections, but in resistant episodes it is necessary to undergo surgical decompression from the first discharge.
Keratoacanthoma
Patients, especially those with frail eyelids, may experience a dome-shaped, puffy appearance with a keratin-filled crater in the center. This plant is characterized by rapid growth and is often located on surfaces that come into contact with the sun, such as the dorsal surface of the hands. Respect what this statement is like from the cells of the hair follicles. If spontaneous regression occurs (after 3–6 months), and if you do not carry out a thorough cleansing, the scar will disappear with a hole in the center. To confirm the diagnosis and exclude the presence of a malignant illness, a new test is carried out.
Squamous cell carcinoma
This expansion of puffiness is especially important in patients with frail age, in areas of sun-damaged skin (sonic keratosis), as well as in patients with immunosuppression. In classic cases, patients suffer from the presence of a keratotic node with an inverted edge, which progressively increases due to the vein being located on the dorsal surface of the hand (Fig. 4). Do it without pain, after the outbreak of infection in deep-rooted fabric, it is possible to remove the virus. Often patients return to the surgeon due to bleeding or the presence of a wound that cannot be healed. Inheritance of metastasis or the development of infection may enlarge the lymph nodes. The bath is lying near the hanging fluff.
Malignant melanoma
If there are changes in the pigment structure - color, size, edges, itching, swelling and bleeding occurs, which can lead to the appearance of malignant melanoma. Puffiness does not often develop on the hand, and untimely treatment of the patient to a confirmed specialist negatively affects the prognosis. Amelanotic melanoma is characterized by a lack of pigmentation and may have the appearance of a granulomatous exophytic solution, which is reminiscent of pyogenic granuloma. Some melanomas grow on the foreheads and under the nails (Fig. 5), they can be confused with chronic paronychia. It is very important to remove the sick person before the surgeon to hang up the swelling.
Heberden's Woozley
Heberden's Woolley - knot-like deformations in the area of the distal interphalangeal angle of the fingers
(often mean and vulgar), which are often stolen from the frail woman. The deformation results from the development of osteophyte and synovial thickening at the border of the joint affected by osteoarthritis. Significant impairment of cerebral function is rare, although patients may experience pain and limb loss. Surgical intervention is indicated only in cases of severe pain or instability of the joint.
Woozley Dupuytren
These hard nodes are located on the distal surface of the pubis, the pubic fascia or the proximal phalanx, where they can adhere to the expanded inferior part of the genital tendon. Dupuytren's wuzley should be located at the base of the fourth finger, if you want to be able to hit any finger. The symptoms are mild, although there may be some discomfort during physical exercise or pain during palpation. The knots may be associated with genital contractures of the metacarpophalangeal or proximal interphalangeal joints. Over the dorsal surface of the proximal interphalangeal tendons, thickening of the subcutaneous tissue (Harrod's body) may appear, so cosmetic ailments may appear in the bath. In patients with Garrod's bodies, there is a clear tendency to develop Dupuytren's disease, and, therefore, the thickening of these tissues is characteristic of Dupuytren's disease. If the patient is unable to place the angled hand on the table, it should be preserved before the surgeon to determine the indication for surgical delivery.
Glomangioma
This mild pustule is characterized by a triad of symptoms: paroxysmal pain, pain on palpation of the painful point, and intolerance to cold. These puffy spots are usually solitary, located on the nail bed or the pads of the fingers. By the time of fastening, you may not notice the fluff (especially if it is rubbed under the nail), but there is still a bluish tint. In addition, you can notice grooves on the surface of the nail, and on radiographs - an erosion of the phalanx. When lightly pressed on the affected area, pain appears. After hanging the fluff comes getting dressed.
Treatment of hygroma / ganglion of the wrist joint
When the disease worsens and discomfort occurs, anti-inflammatory drugs are used.
If the formation increases, if there are restrictions in movement, the hand becomes numb and hurts, you need to contact a surgeon or traumatologist. Surgery may be needed.
Surgical intervention is required if the formation has a cellular structure or its size increases.
During the operation, the hygroma is removed along with the capsule.
The safest and least traumatic removal of hygroma is using a laser. In addition to laser removal, endoscopic excision of hygroma of the wrist joint has proven itself well.
It is important to remember that after removal by any method, relapse may occur.
The operation to remove hygroma is simple, performed under local anesthesia:
- A special needle is inserted into the cyst cavity;
- Liquid contents are removed;
- The cavity is washed with an antiseptic, and an antibiotic can be used.
After removing the hygroma, a bandage is applied for several weeks. Premature removal of the bandage can provoke re-formation of the cyst.
Causes of growth on the finger joint
The lump mainly forms on the middle, thumb and ring fingers. Treatment for a growth on the phalanx depends on the cause of its appearance. Bumps on the fingers can form due to joint diseases, infections, tumors and other reasons.
Joint diseases
Arthrosis
Osteoarthritis of the fingers is a degenerative inflammatory disease of the joints. A lump on the thumb can often be a symptom of arthrosis. The formation of a lump on the bend, at the base of the thumb on the hand, is also called rhizarthrosis. This occurs due to the high mobility of the finger. It begins with minor pain during normal household activities. Gradually, the joint becomes deformed, movement causes discomfort, and bumps grow on the joint of the thumb.
Polyarthrosis is characterized by the appearance of lumps on several joints. The fingers become deformed, the bumps cause discomfort and pain.
Arthritis
Arthritis of the fingers is a chronic disease associated with wear and tear of the articular cartilage. Normally, cartilage is smooth, glides easily and does not cause movement difficulties. As they wear out, pain may occur. Bumps on the joints can be caused by this disease.
Older people are at risk. The older a person gets, the more worn out tissues and organs are, including joints. There are several types of arthritis, classified according to the cause that causes it:
- rheumatoid arthritis - characterized by damage to connective and cartilaginous tissues;
- infectious – occurs when viruses and bacteria enter the body. They can enter the body through an open wound, during surgery or unsterile injections;
- gouty - characterized by a violation of the body's metabolic processes and the accumulation of uric acid in the blood. The cause of this disease may be poor kidney function, in which they are unable to process and remove uric acid.
Orthopedic surgeon Eduard Viktorovich Zhezherya comments:
In cases where the cause of the formation is related to joint diseases, people who are elderly or who expose their hands to excessive stress are at risk.
Infectious diseases
Infectious diseases can also cause the formation of bumps on the fingers. Mostly, infections underlie other diseases, such as arthritis, but can also be an independent factor. Infections affect the entire body as a whole and can cause destruction of connective or cartilage tissue. Infectious diseases occur in people of any age and gender.
Infections enter the body through open wounds due to the use of unsterile syringes and during surgery.
Other reasons
Other reasons for the formation of bumps on the fingers include:
1) Work associated with monotonous stress on the joints is a common cause of deformation of the fingers and the formation of growths on them.
2) Benign tumors.
- Hygroma. Nodes on the fingers can be the result of benign tumors, such as hygroma. Hygroma is a bubble with a gel-like liquid. The disease is not difficult to diagnose and is treatable. The bubble is easily palpable, it is elastic and not painful. Sometimes, hygroma goes away on its own and appears again. It is not recommended to puncture the blisters, since after this the hygroma will return with a 90% probability. It's better to see a doctor. Removing hygroma forever will not be difficult for a specialist.
- Warts. A tumor on the fingers is often caused by a papilloma virus, is painless, and operable.
- Fibroma. An extremely rare type of neoplasm. A characteristic symptom is acute pain caused by compression of nerve endings.
3) Malignant tumors.
- Malignant tumors include cancerous tissue lesions with damage and the formation of metastases. Known types of diseases include skin cancer or sarcoma.
4) Growths on the bones of the middle fingers, often formed in people who have to write a lot. For example, teachers or doctors. The lump appears from the pressure of a pen on the joint of a finger. In this case, no treatment is required. If a lump on a finger grows and causes discomfort, it can, of course, be removed. You can get rid of it by starting to use a pen with a soft nozzle. It is better to write while holding the pen with your fingertips. The callus will go away on its own if you no longer need to write a lot.