Causes, symptoms, diagnosis of hygroma. Treatment of hand hygroma and other localization
Hygroma is a volume formation located in the joint area, which is a cavity filled with liquid. This is both a cyst and a tumor. There is no danger, but often the pathology leads to the appearance of cosmetic defects and noticeable pain. Treatment of hygroma of the hand is a common manipulation in the operating practice of orthopedists, when conservative treatment is ineffective.
Causes of hygroma
There is still no consensus on the causes of this disease. There are three theories, each of which has only been partially proven:
- inflammatory;
- neoplastic;
- dysmetabolic.
According to the first, the factor in the development of the disease is the inflammatory process. Proof of this is a clear connection between occupational trauma and tendovaginitis, bursitis, and the appearance of hygromas in the joint area. Usually, the cavity occurs in a weak point of the tendon canal or joint bag and connects with the cavity of the main capsule. Over time, the channel can be closed with scar tissue and the hygroma becomes an independent formation.
According to the second theory, a hygroma is considered a benign tumor that grows from atypical cells to the outside. At first, it is just a microscopic nodule, in which a cavity is later formed. Proof of this is the frequent detection of atypical cells in its contents during cyst puncture. The second evidence is the recurrence of hygroma with careless removal, when areas of the capsule wall remain in the joint area.
The third theory suggests that in some diseases, which often accompany a hygroma, the production of synovial fluid by the capsule of the joint at some point begins to exceed the ability of the capsule to absorb it back. When the intra-articular pressure increases, a protrusion is formed, which later becomes a hygroma.
The causes of fetal neck hygroma are completely different. The disease is formed due to a violation of the development of the lymphatic system in the fetal period (approximately at the 12th week). This hygroma is called lymphangioma, it grows from lymphatic vessels and has nothing to do with joint structures.
Symptoms
The main symptom is the presence of a volume formation of the corresponding localization. Sometimes it is accompanied by pain, especially severe when the growing cyst squeezes nearby nerve endings. At the same time, there is a violation of skin sensitivity in the innervation zone of the corresponding nerve. Pain can also cause disruption of tissue nutrition if arteries are compressed.
Sometimes there is a violation of the mobility of the corresponding joint. It is usually associated with pain that occurs during movement.
Diagnosis of hygroma
To make a diagnosis, as well as to differentiate various types of peri-articular pathology, use:
- X-ray, which allows you to distinguish a hygroma from an osteosarcoma, a hematoma, a lipoma, a tuberculous focus of osteomyelitis;
- computed tomography, which allows you to determine not only the structure of the tumor, but also to reveal its exact location and connection with joint structures;
- puncture biopsy, with the help of which the contents of the cyst are obtained for analysis for the presence of atypical cells - this makes it possible to distinguish a benign process from a malignant one. If pus, caseous masses, or blood are detected in the punctate, the diagnosis of hygroma is considered doubtful.
Treatment of hygroma
Traditional medical practice shows that it is impossible to get rid of this formation with conservative treatment. And although there are miraculous folk methods on the Internet, how to treat a hygroma on the leg, you cannot do without surgery. Perhaps this is due to the tumor nature of the formation, which contributes to relapse.
Before the intervention, the patient must be prepared: the doctor determines the blood clotting ability, the level of glucose and electrolytes. In the presence of hemophilia and other blood pathology, the level of coagulation factors should be adjusted in advance.
The operation is usually performed under local anesthesia. Before it begins, a test is conducted for the anesthetic that is planned to be used. Also, a broad-spectrum antibiotic (usually 3-4 generation cephalosporins) is prescribed before surgery for preventive purposes.
The incision is made so as to gain maximum access to the cyst, while remembering that a bad incision is a guarantee of poor healing. The hygroma is isolated by a blunt method, trying not to damage its capsule, the leg is crossed between two clamps, the base is either bandaged or sewn up. Then the wound itself is sewn up. The removed hygroma is sent for histological examination.
Removal of hygroma on the wrist by laser is carried out according to the same rules as the traditional method. The only difference is that a laser scalpel is used instead of a conventional scalpel. This allows you to reduce blood loss. A laser scalpel can be removed in any localization, for example, a hygroma of the knee joint. After the operation, recovery of working capacity occurs within 2-3 weeks.
Postoperative period
In the absence of inflammation in the postoperative wound, sutures are removed after 5-7 days. If the wound becomes infected, they can be removed earlier to re-sanitize the wound with antiseptics. In this case, recovery will be longer.
After removal of hygroma of the carpal joint, the patient, whose work is associated with constant traumatism of this area, is recommended to change his profession. Only in this way can the probability of relapse be reduced to a minimum. Hygroma of the foot in children is most often caused by flat feet, so it needs to be treated in a timely manner. This will avoid not only the recurrence of the pathology, but also the development of other problems in adulthood.
Special situations
Sometimes the patient can crush the hygroma. Previously, they even tried to treat her in this way and operated only in case of relapse.
The consequences of a hygroma on a ruptured finger are usually insignificant, because its contents are sterile. Nevertheless, the patient should observe this area. In case of signs of inflammation or its rapid further growth, the experts of our dobrobut.com clinic recommend to consult a doctor immediately.
Hygroma is more of a cosmetic defect, although sometimes it can cause a lot of inconvenience. In any case, hygroma should be treated with specialists.
Related services:
Orthopedics and traumatology
Arthroscopy
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