Ganglion Cyst?

[Dr Steve]

Before I go setting up a doctor's appt, I wanted to check with you first. About 4 inches up from my wrist, I have what looks like a ganglion cyst on my forearm. From the pictures and descriptions I found online, it sounds very similar. However, ganglion cysts seem to almost always form on the wrist, hands, or feet, and so I'm confused if that's whats on my forearm. It's about the size of a nickel, semi-hard lump under the skin but it hasn't turned red or pink yet. Should I worry andget to the doctor right away, or wait a week? I noticed it 3 or 4 days ago and its gotten just a little bit bigger. Thanks as always, great hearing you on the buddays and Weird Medicine has been my fave 202 podcast



You are right that ganglion cysts are generally seen around joints. The reason for this is that mobile joints are surrounded by a membrane called "synovial tissue". This has an elastic inner surface, and a rather tough, fibrous outer surface. If the outer surface splits for whatever reason, the elastic inner sheath will bloop out, similar to a tire innertube (if you're old enough to remember those). Ganglion cysts are filled with an amazingly clear and colorless gel.

One treatment for a ganglion is to remove it surgically, and "old school" method was to smash the ganglion with a softcover book (a Bible was often used, somewhat irreverently, for it's soft leather cover and nice heft)...if you split the capsule of the cyst, it generally won't come back. The gel just seeps out and is resorbed by the body.

We capitalize on the clear gel quality of the ganglion by shining a light behind it...if it lights up "like ET's finger" (as PA John so eloquently stated on the first weird medicine (in a rare moment of lucidity)), it's likely to be a ganglion.

Now, your nodule may be another thing altogether. If it's a ganglion, it just has a really long stalk. If it's not, it's growing and will bear further examination by a health care provider. The better part of valor is to get it checked out.

Write back after they've looked at it and let us know what they found.


your friend,



Steve

[Alice S. Fuzzybutt]

You are right that ganglion cysts are generally seen around joints. The reason for this is that mobile joints are surrounded by a membrane called "synovial tissue". This has an elastic inner surface, and a rather tough, fibrous outer surface. If the outer surface splits for whatever reason, the elastic inner sheath will bloop out, similar to a tire innertube (if you're old enough to remember those). Ganglion cysts are filled with an amazingly clear and colorless gel.

One treatment for a ganglion is to remove it surgically, and "old school" method was to smash the ganglion with a softcover book (a Bible was often used, somewhat irreverently, for it's soft leather cover and nice heft)...if you split the capsule of the cyst, it generally won't come back. The gel just seeps out and is resorbed by the body.

We capitalize on the clear gel quality of the ganglion by shining a light behind it...if it lights up "like ET's finger" (as PA John so eloquently stated on the first weird medicine (in a rare moment of lucidity)), it's likely to be a ganglion.

Now, your nodule may be another thing altogether. If it's a ganglion, it just has a really long stalk. If it's not, it's growing and will bear further examination by a health care provider. The better part of valor is to get it checked out.

Write back after they've looked at it and let us know what they found.


your friend,



Steve

I've had a ganglion cyst since college (20 plus years). Aside from hitting it with a flaming bible, you're kind of stuck with it.

I asked a doctor about getting it removed and my doctor told me-- it will very well come back.

So, unless you're having pain, I'd just leave it. It's never caused me any pain or bother.

Kudos to you Dr. Steve. Just my 2-cents!

Petrina
AKA Alice S. Fuzzybutt

[Dr Steve]

I've had a ganglion cyst since college (20 plus years). Aside from hitting it with a flaming bible, you're kind of stuck with it.

I asked a doctor about getting it removed and my doctor told me-- it will very well come back.

So, unless you're having pain, I'd just leave it. It's never caused me any pain or bother.

Kudos to you Dr. Steve. Just my 2-cents!

Petrina
AKA Alice S. Fuzzybutt

totally agree...if his is indeed a ganglion. I'd confirm that first, then you can decide to live with it if you like. :-)

I could tell you in a second if I could examine it myself; since that's impossible, I'd still like to get this checked out.

Yes, the ganglion surgery is quite a pain...apparently they have to trace the thing all the way back to the defect in the synovium, then fix said defect without introducing a new one. It's pretty tricky from what my ortho friends tell me. Of course, they just like telling me how great they are so i have to take it all with a grain of salt. ha

[EffMeBoobs]

I see these from time to time on the job since I'm an ultrasound techie. They're fun to scan!

[Jennitalia]

i'll hit it with a bible, or with whatever book you like :smile:

[Bob Impact]

I have one on each wrist. The one on the left side occasionally gets so bad it makes that hand (my dominant hand as well) go numb. I've looked into the surgery, but I'm really not all that excited about the prospect. It doesn't help that I have arthritis in that wrist either. My orthopedic also recommended I do not use the Bible method and have the surgery instead, though I'm not sure if that is only because mine is recurring and problematic. The right side is always there, but never hurts.

[Friday]

i had a ganglion in my left hand about an inch or so up from the wrist when i was young.
they removed it once and it did, indeed, grow back.

but my next surgeon... dr livingston of bergen county and the ny knicks (at the time).... went in there and got it out flawlessly the second time. he's the best. i have a frankenstein scar about an inch long on the crease of my hand, which has filled in with melanin over time so it doesn't look odd unless you are really looking for it.

i am glad they removed it though. it was an odd growth to have as a pre-teen female, and it was at times uncomfortable.

[Alice S. Fuzzybutt]

The odd thing that I've noticed about it is that, from time to time, it diminishes in size or, as in my case right now, it's completely disappeared.

But much like The Terminator, it WILL be back.

[PilotJeff]

Wasn't there a show a few years back on WNEW where Ron slammed Fez's wrist with a dictionary or phone book to break one of these up? It's funny, I hadn't thought about that in years, but reading this thread reminded me of how much I laughed that evening.

[Freakshow]

Can one form near the elbow as well? I have a large lump near my elbow that looks like one of these cysts. Someone once told me what it was (I don't remember what they said, though), and that even if removed it could possibly come back, so I never did anything about it.

It tends to freak people out, though.

[Dr Steve]

Can one form near the elbow as well? I have a large lump near my elbow that looks like one of these cysts. Someone once told me what it was (I don't remember what they said, though), and that even if removed it could possibly come back, so I never did anything about it.

It tends to freak people out, though.


A LARGE lump near your elbow may be an "olecranon bursitis".

The olecranon bursa is a lubricating sac that helps the skin flow nicely over the elbow joint without catching.

http://www.eorthopod.com/images/ContentImages/elbow/elbow_bursitis/elbow_bursitis_anatomy01.jpg

Normally it's totally flat, like a ziplok with the air sucked out of it (and a little KY Jelly smeared on both inside surfaces). If you lean on it a lot, or traumatize it in other ways, it can fill up with fluid and become a problem.

http://www.eorthopod.com/images/ContentImages/elbow/elbow_bursitis/elbow_bursitis_intro01.jpg

If it gets infected, it can be a REAL problem.

If it bothers you, I'd see an orthopedist (bone and joint surgeon) and see if it needs help.


Good luck!


steve

[Freakshow]

You said sac.


Perhaps it's not as 'near' the elbow as I though. I took a grusome picture (it's really hard to take a picture of your arm, by the way). It's not really bothering me, but I sorta want to know what it is so I can at least tell people.

http://farm4.static.flickr.com/3164/2653915942_791e4f4479.jpg

Not the greatest picture.

[MojoTeddybear]

Wasn't there a show a few years back on WNEW where Ron slammed Fez's wrist with a dictionary or phone book to break one of these up? It's funny, I hadn't thought about that in years, but reading this thread reminded me of how much I laughed that evening.

Yup, in fact Ron did a couple of times during their WNEW tenure.

[Bob Impact]

The odd thing that I've noticed about it is that, from time to time, it diminishes in size or, as in my case right now, it's completely disappeared.

But much like The Terminator, it WILL be back.

Yeah that happens with both of mine, with much more of a range of sizes on the right side.

[Badinia]

I had one on my hand surgically removed. I went under anesthesia and apparently was talking very dirty to the surgeon on my way down. When I came in for my checkup, he said "you're a very funny lady", but when I asked him what was said he just blushed and giggled.

[Dr Steve]

You said sac.


Perhaps it's not as 'near' the elbow as I though. I took a grusome picture (it's really hard to take a picture of your arm, by the way). It's not really bothering me, but I sorta want to know what it is so I can at least tell people.

http://farm4.static.flickr.com/3164/2653915942_791e4f4479.jpg

Not the greatest picture.

yeah, that's not a ganglion or an olecranon bursa. Try to "transilluminate" it by putting a penlight behind it and see if it's filled with clear fluid (that's encouraging). It could be a lot of things, including a sebaceous cyst (like Rich Vos had behind his ear) or a lipoma (a benign, non-cancerous "tumor" of fat cells).

Here's a good rule of thumb: if something is growing on your body in a place where it shouldn't be, get it checked out. It'll take 2 seconds for a health care provider to determine whether it's something to worry about (and 95% of them are nothing to worry about; it's the 5% or less that make it worth seeing someone.)

Get it checked out and let me know what they say, ok? thanks for sending in the picture, that helped a lot to know what route to take.

[Dr Steve]

Let me ask you all something...is it less confusing for me to COPY posts and move them to new threads (so they don't just disappear in the original thread), or for me to MOVE them (so there aren't two copies floating around).

I just made a new thread about the cyst on freak's arm, but I left the old posts here so he wouldn't think I'd deleted his posts for some reason.

I'm new at this, so any recommendations are welcome.



steve

[Dr Steve]

I had one on my hand surgically removed. I went under anesthesia and apparently was talking very dirty to the surgeon on my way down. When I came in for my checkup, he said "you're a very funny lady", but when I asked him what was said he just blushed and giggled.

HA! This was the reason I didn't have my first scope for so long. I was terrified I'd just start yelling inappropriate stuff and it'd get out and my reputation (such that it is) would be ruined.

I'm glad to hear my fears weren't totally off the wall, though I apparently just tell everyone how wonderful they are when I'm out.

[Badinia]

HA! This was the reason I didn't have my first scope for so long. I was terrified I'd just start yelling inappropriate stuff and it'd get out and my reputation (such that it is) would be ruined.

I'm glad to hear my fears weren't totally off the wall, though I apparently just tell everyone how wonderful they are when I'm out.

I know! It's your Id out takin' a walk on its own! Scary...

[suggums]

thanks for the thread dr. steve! i appreciated all the responses, i don't get on here much and i just wanted to wait it out a bit before responding. im still not sure what it is but its going away slowly now, so i think i'll hold off on the doc a bit longer. i was told it might also have been a spider bite, and also read about fatty buildups under the skin, maybe it was that? either way, seems to be resolving itself. for frame of reference, it looked similar to freakshow's arm bump but much smaller and further down my forearm. thanks again for advice everyone

[Dr Steve]

thanks for the thread dr. steve! i appreciated all the responses, i don't get on here much and i just wanted to wait it out a bit before responding. im still not sure what it is but its going away slowly now, so i think i'll hold off on the doc a bit longer. i was told it might also have been a spider bite, and also read about fatty buildups under the skin, maybe it was that? either way, seems to be resolving itself. for frame of reference, it looked similar to freakshow's arm bump but much smaller and further down my forearm. thanks again for advice everyone

it stimulated a lot of discussion, so thanks for posting it.

If it's going away on its own, I think you can get away with just watching it. If it grows/comes back, turns red, starts draining, or becomes painful(or if you have any other concerns about it) go see someone!

keep us in the loop.


your friend,


steve