Ganglion cyst
Encyclopedia
A ganglion cyst, also known as a bible cyst, is a swelling that often appears on or around joint
s and tendon
s in the hand
or foot
. The size of the ganglion or cyst
can vary over time. It is most frequently located around the dorsum
of the wrist
and on the finger
s. The term "Bible bump" comes from a common treatment in the past that consisted of hitting the cyst with a Bible
or another large book. Rupture of the cyst is rarely curative - which means, trying to pop it probably won't fix it and might make it worse.
cysts are idiopathic
, but presumably reflect a variation in normal joint or tendon sheath
function. Cysts near joints are connected to the joint and the leading theory is that a type of check valve
forms that allows fluid out of the joint, but not back in. The cyst contains clear fluid similar to, but thicker than, normal synovial fluid
. They are most often found around the wrist joint, especially at the scapho-lunate joint, which accounts for 80% of all ganglion cysts.
of the wrist is becoming available as an alternative to open excision of ganglion cysts.
Another treatment applied is the use of a needle to drain the fluid from the cyst, however if the fluid has become thick due to the passage of time this treatment is not always effective.
An out-dated method of treating a ganglion cyst was supposedly to strike the lump with a large heavy book, causing the cyst to rupture and drain into the surrounding tissues. An urban legend states that since even the poorest households often possessed a Bible, this was commonly used, which led to the nicknaming of ganglion cysts as "Bible bumps" or "Gideon's disease."
Joint
A joint is the location at which two or more bones make contact. They are constructed to allow movement and provide mechanical support, and are classified structurally and functionally.-Classification:...
s and tendon
Tendon
A tendon is a tough band of fibrous connective tissue that usually connects muscle to bone and is capable of withstanding tension. Tendons are similar to ligaments and fasciae as they are all made of collagen except that ligaments join one bone to another bone, and fasciae connect muscles to other...
s in the hand
Hand
A hand is a prehensile, multi-fingered extremity located at the end of an arm or forelimb of primates such as humans, chimpanzees, monkeys, and lemurs...
or foot
Foot
The foot is an anatomical structure found in many vertebrates. It is the terminal portion of a limb which bears weight and allows locomotion. In many animals with feet, the foot is a separate organ at the terminal part of the leg made up of one or more segments or bones, generally including claws...
. The size of the ganglion or cyst
Cyst
A cyst is a closed sac, having a distinct membrane and division on the nearby tissue. It may contain air, fluids, or semi-solid material. A collection of pus is called an abscess, not a cyst. Once formed, a cyst could go away on its own or may have to be removed through surgery.- Locations :* Acne...
can vary over time. It is most frequently located around the dorsum
Dorsum (anatomy)
In anatomy, the dorsum is the upper side of animals that typically run, fly, or swim in a horizontal position, and the back side of animals that walk upright. In vertebrates the dorsum contains the backbone. The term dorsal refers to anatomical structures that are either situated toward or grow...
of the wrist
Wrist
In human anatomy, the wrist is variously defined as 1) the carpus or carpal bones, the complex of eight bones forming the proximal skeletal segment of the hand;...
and on the finger
Finger
A finger is a limb of the human body and a type of digit, an organ of manipulation and sensation found in the hands of humans and other primates....
s. The term "Bible bump" comes from a common treatment in the past that consisted of hitting the cyst with a Bible
Bible
The Bible refers to any one of the collections of the primary religious texts of Judaism and Christianity. There is no common version of the Bible, as the individual books , their contents and their order vary among denominations...
or another large book. Rupture of the cyst is rarely curative - which means, trying to pop it probably won't fix it and might make it worse.
Cause
GanglionGanglion
In anatomy, a ganglion is a biological tissue mass, most commonly a mass of nerve cell bodies. Cells found in a ganglion are called ganglion cells, though this term is also sometimes used to refer specifically to retinal ganglion cells....
cysts are idiopathic
Idiopathic
Idiopathic is an adjective used primarily in medicine meaning arising spontaneously or from an obscure or unknown cause. From Greek ἴδιος, idios + πάθος, pathos , it means approximately "a disease of its own kind". It is technically a term from nosology, the classification of disease...
, but presumably reflect a variation in normal joint or tendon sheath
Tendon sheath
A tendon sheath is a layer of membrane around a tendon. It permits the tendon to move.It has two layers:* synovial sheath* fibrous tendon sheathFibroma of the tendon sheath has been described....
function. Cysts near joints are connected to the joint and the leading theory is that a type of check valve
Check valve
A check valve, clack valve, non-return valve or one-way valve is a mechanical device, a valve, which normally allows fluid to flow through it in only one direction....
forms that allows fluid out of the joint, but not back in. The cyst contains clear fluid similar to, but thicker than, normal synovial fluid
Synovial fluid
Synovial fluid is a viscous, non-Newtonian fluid found in the cavities of synovial joints. With its yolk-like consistency , the principal role of synovial fluid is to reduce friction between the articular cartilage of synovial joints during movement.-Overview:The inner membrane of synovial joints...
. They are most often found around the wrist joint, especially at the scapho-lunate joint, which accounts for 80% of all ganglion cysts.
Treatment
With surgery, the recurrence rate is reduced to 5 to 10% if the check valve at the joint capsule is removed. ArthroscopyArthroscopy
Arthroscopy is a minimally invasive surgical procedure in which an examination and sometimes treatment of damage of the interior of a joint is performed using an arthroscope, a type of endoscope that is inserted into the joint through a small incision...
of the wrist is becoming available as an alternative to open excision of ganglion cysts.
Another treatment applied is the use of a needle to drain the fluid from the cyst, however if the fluid has become thick due to the passage of time this treatment is not always effective.
An out-dated method of treating a ganglion cyst was supposedly to strike the lump with a large heavy book, causing the cyst to rupture and drain into the surrounding tissues. An urban legend states that since even the poorest households often possessed a Bible, this was commonly used, which led to the nicknaming of ganglion cysts as "Bible bumps" or "Gideon's disease."