Wrist Hygroma - Why Is It Dangerous? Causes And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Hygroma of the wrist

Hygroma of the wrist is a benign cystic tumor that is represented by connective tissue walls. There is fluid inside such a neoplasm. The tumor can form anywhere there is connective tissue, but most often it forms in the wrist.

Content:

• What is Wrist Hygroma?
• Causes of the appearance of a hygroma of the wrist
• Symptoms of the hygroma of the wrist
• Why is the hygroma of the wrist dangerous?
• Diagnostics
• Treatment

What is Wrist Hygroma?

The hygroma of the wrist is represented by the outer shell, which consists of connective tissue. It grows from the wrist joint or from the synovial bursae with the appropriate localization. The tumor is divided by the thinnest partitions. Each compartment is filled with liquid, which is produced by the walls of the hygroma themselves. The liquid is thick, has a whitish-yellow color.

Hygroma has an upward trend. It increases in size due to cell division, which produce large volumes of fluid.

Hygroma does not become malignant over time. It does not spread metastases, therefore it does not pose a threat to human life. To a greater extent, this tumor causes aesthetic discomfort. Sometimes it can cause painful sensations, as it presses on the tissues and nerve endings that are located in the immediate vicinity of it.

Causes of the appearance of a hygroma of the wrist

Until now, the exact reasons that lead to the appearance of hygroma have not been established. However, the main risk factors that can provoke the growth and development of a tumor are highlighted.

These include:

• Anatomical features of the human hand. The bursae of muscles in most people are located in deep structures. They are protected by soft tissues and fatty layers. This allows you to protect them from injury. In some people, these bags are close to the surface, so they are often damaged, which can lead to the formation of a hygroma.
• Excessive stress on the wrist. If a person, due to professional activity, performs the same type of movement with the wrist joint, this increases the likelihood of injury to the tendons and the joint capsule itself. Therefore, the hygroma on the wrist is more often formed among programmers, typists, musicians, builders, loaders, etc.
• The presence of chronic tendovaginitis or bursitis. These diseases are accompanied by damage to the tendons and bursae. Their tissues become inflamed, more blood flows to them, healthy cells are damaged, and begin to divide more actively. If such a pathological process is present on an ongoing basis, then this increases the likelihood of hygroma formation.
• Hereditary predisposition. There is evidence that hygromas appear more often in blood relatives.
• Belonging to the female sex. It has been established that hygromas appear 3 times less often in men.
• Treatment of hygroma in the past. This tumor is more likely to relapse than other neoplasms. Even the operation does not guarantee that after a while it will not appear again.

Symptoms of the hygroma of the wrist

Most often, hygromas form on the dorsum of the wrist joint. The main symptoms of a tumor are the following:

• The tumor appears under the skin. It is clearly visible.
• Most often, the tumor is single, although sometimes several hygromas can form at once.
• Hygroma of the wrist is soft, but if the disease has a long course, or a lot of fluid accumulates in the cyst cavity, it can become elastic and elastic. Bone or cartilage-like tumors on the wrist are rare.
• When pressing on the hygroma, a person experiences painful sensations. They can increase after an active load on the limb.
• Excessive work of the wrist joint can lead to the fact that the tumor will increase in size. In a state of rest, it returns to its usual state again.
• The hygroma has the shape of a regular ball with clear boundaries. It is easy to displace it relative to the skin.
• The dermis over the tumor is not changed, has a flesh color, but with strong tension it can peel off and become thinner. If the skin turns red, then this will indicate an inflammation of the hygroma, which can be aseptic or purulent.
• The average diameter of the wrist hygroma is 3 cm, although sometimes the tumor can reach 6 cm and even more.

Depending on the exact location of the hygroma, some of its features are distinguished.

If the tumor has formed on the back of the wrist, then it will have the following characteristics:

• The average size of the hygroma is 5 cm, its height is 2 cm.
• If the tumor grows from the joint, then it is not very mobile. When the hygroma grows from the bursa, it moves with the vagina.
• A hygroma at the dorsum of the wrist can put pressure on the terminal section of the radial artery, which runs there. Its compression is manifested by pain in the thumb, which intensifies after exertion on it.
• Sometimes a hygroma growing on the back side can lead to clamping of nerve endings, which will manifest itself as a violation of the sensitivity of the thumb, index and / or middle finger (with damage to the radial nerve). If the sensitivity of the little or ring finger suffers, this indicates that the tumor is pressing on the ulnar nerve.

When a hygroma forms on the palmar side of the wrist, it has the following characteristics:

• The average tumor size is 2 cm in diameter.
• The hygroma, which grows from the synovial sheath of the thumb, has the maximum mobility.
• If the tumor begins to press on the arteries, then this is manifested by weakness and pain in the hand, which intensifies when it bends.

Although multiple symptoms of hygroma have been described in the section, they rarely fully manifest themselves. Most of the patients do indicate that the tumor does not give them any inconvenience, except for minor discomfort after a bruise or with intense limb movements.

Why is the hygroma of the wrist dangerous?

Many people with hygroma are of the opinion that it is not necessary to remove the tumor, since it is not capable of degeneration. In fact, you need to get rid of the neoplasm. The fact is that, like any other cysts, the hygroma tends to grow. Many nerve fibers and blood vessels run in the wrist area.

As it grows in size, the hygroma will begin to put pressure on them, which will lead to such violations as:

• Deterioration of the sensitivity of the hand and fingers.
• Paresthesias and paresis of the hand.
• Painful sensations in the corresponding area. The pain will resemble lumbago.
• Deterioration of hand nutrition against the background of compression of blood vessels. In this case, the skin of the hand will suffer, the nails may crumble, the muscles will become weak. In severe cases, small ulcerations and pustules may appear.
• If the veins are pinched, then it threatens with edema.

Therefore, if a hygroma is found, you need to consult a doctor and remove the tumor in a timely manner. Another reason to get rid of a neoplasm is a cosmetic defect.

Diagnostics

Diagnosis of a hygroma begins with its examination, palpation and listening to the patient's complaints.

To make sure that the tumor is benign and distinguish it from other neoplasms, a person can be sent to instrumental examination methods such as:

• Radiography of the hand. This technique allows you to distinguish hygroma from osteosarcoma and other pathologies of bone tissue.
• Ultrasound. This method is the most accessible and informative in terms of diagnosing a hygroma. Ultrasound allows you to assess the size of the tumor, gives information about its structure and connection with the surrounding tissues.

If the doctor has doubts about the benign quality of the tumor, then he can refer the patient to an MRI, as well as a puncture. However, such studies are rarely prescribed for hygroma.

Treatment

Modern ideas about the treatment of hygroma boil down to the fact that it needs to be removed surgically. Other treatments are ineffective.

The operation is necessary for the following reasons:

• The tumor will grow in size if not removed. Surgical intervention is the only reliable way to prevent complications of hygroma.
• Fast recovery period. If a person consults a doctor at an early stage of hygroma formation, then the volume of the operation will be insignificant. Within a few days, the patient will be able to return to their usual lifestyle.
• Reducing the risk of disease recurrence. During the operation, the doctor has the ability to remove all elements of the tumor. It will not be possible to do this in any other way.
• Improving the appearance of the wrist. The hygroma on the wrist will be visible. If removed, the scar remains subtle.

The operation is most often carried out in a standard way, that is, the hygroma is excised with a scalpel. Although, if desired, a person can choose a laser technique for removing the tumor. However, most experts point out that it is better to opt for the classical technique.

Operation execution algorithm:

• The patient is given a local anesthetic. As a rule, general anesthesia for hygroma is used only in severe cases, when the tumor reaches an impressive size.
• The skin, which is located above the hygroma, is treated with an antiseptic solution.
• The tissue surrounding the neoplasm is dissected in layers to expose it.
• Particular attention should be paid to the base of the tumor. If small cysts are found in the surrounding tissues, then they must also be removed.
• Hygroma is not opened, it is removed entirely.
• The wound is sutured, covering it from above with a sterile bandage. The brush is fixed with a plaster cast. Immobilization is performed when the wrist hygroma is large.

The procedure takes about half an hour. During this period, the patient will not experience pain. During rehabilitation, unpleasant sensations may occur. They are stopped by taking painkillers. The dressing needs to be changed every day. After 5-7 days, you can refuse to wear it.

Is it possible to get rid of hygroma in conservative ways?

In the medical literature of past years, you can find information about the fact that hygromas are treated using conservative techniques. For example, with the use of physiotherapy methods (UFO, UHF, magnetotherapy, etc.), with the use of puncture or with the introduction of antibiotics, sclerosing drugs into the cyst, etc. As practice has shown, these procedures are not effective. After some time, the hygroma grows again. After conservative therapy, hygroma recurs in 80-90% of cases.

The fact is that the tumor is permeated with capillaries. There are not many of these vessels, but enough to support the vital activity of the cells of the neoplasm. Their defective removal will lead to the fact that the tumor will grow again. In addition, warming up and other physiotherapeutic techniques contribute to the fact that the tissues of the hygroma will receive enhanced nutrition, and it will begin to grow faster. Therefore, the only way to get rid of it is through surgery. Although in some cases, even after it is carried out, the tumor recurs. The risk is 8-20%.

Wrist hygroma is a benign neoplasm that is best treated early in its development. The operation is not complicated and is free of charge in state medical institutions.

The author of the article: Bykov Evgeny Pavlovich | Oncologist, surgeon

Education: graduated from residency at the Russian Scientific Oncological Center. N. N. Blokhin "and received a diploma in the specialty" Oncologist"