Wrist ganglions can be classified according to location and cause:

1. Dorsal ganglion:
   • Located on the extensor side of the wrist, often over the carpal bone (scapholunate region).
2. Ventral ganglion:
   • On the flexor side of the wrist near the radial artery.
3. Tendon sheath ganglion:
   • Arises along tendon sheaths, often due to mechanical overuse.
4. Intracapsular ganglion:
   • Located within the joint capsule and often associated with degenerative joint changes.

The exact cause of the formation of a ganglion is not fully understood, but the following factors are often associated:

• Overload:
  • Repeated mechanical stresses, especially from monotonous movements like typing or heavy manual work.
• Trauma:
  • Injuries or microtraumas can weaken the joint capsule or tendon sheaths and promote the formation of a ganglion.
• Degenerative changes:
  • Wear and tear of the joint capsule or cartilage leads to increased production of joint fluid, which can accumulate in a ganglion.
• Anatomical weaknesses:
  • Weaknesses in the joint capsule can promote the formation of a cyst.
• Rheumatic diseases:
  • Inflammatory changes in the joint area can increase the risk of a ganglion.

The symptoms of a ganglion vary depending on size and location:

- Swelling:

- A visible or palpable, usually soft and elastic bulge that can vary in size.

- Pain:

- Ganglions can be painful, especially under stress or pressure.

- Movement restrictions:

- Large ganglions can restrict wrist movements.

- Aesthetic impairment:

- Affected individuals often find the visible bulge disturbing.

- Neurological symptoms:

- In rare cases, a ganglion can compress nerve structures and cause tingling or numbness.

The diagnosis of a ganglion is made through medical history, physical examination, and, if necessary, imaging techniques:

• Medical history:
  • The doctor inquires about symptoms, the course of the swelling, and possible triggering factors such as injuries or overuse.
• Clinical examination:
  • Palpation of the swelling, checking the mobility of the wrist, and identifying tenderness.
• Imaging techniques:
  • Ultrasound: Visualization of fluid accumulation and differentiation from other tissue lesions.
  • MRI: Detailed visualization of ganglia and surrounding structures, especially for deep-seated ganglia.
  • X-ray: To assess possible degenerative changes or bony anomalies.

Conservative Therapy

In many cases, no surgical treatment is necessary, and the ganglion can spontaneously regress:

• Observation:
  • Regular monitoring if the ganglion does not cause discomfort.
• Immobilization:
  • Use of wrist splints to relieve and reduce swelling.
• Aspiration:
  • Aspiration of the ganglion to remove the fluid; often combined with a cortisone injection to reduce inflammation.

Surgical Therapy

For painful, recurrent, or function-limiting ganglions, a surgical procedure may be necessary:

• Ganglion excision:
  • Complete removal of the ganglion including the base to prevent recurrence.
• Minimally invasive surgery:
  • Arthroscopic removal for smaller ganglions or accompanying joint problems.

To prevent ganglions on the wrist, it is recommended:

1. Avoiding overstrain: Limiting repetitive movements and monotonous strains on the wrist.
2. Ergonomic workplace design: Using wrist supports and taking breaks during computer-based activities.
3. Strengthening wrist muscles: Targeted exercises to improve stability and resilience.
4. Early treatment: Immediate clarification of complaints or swelling in the wrist area to avoid greater damage.