Hand and wrist pathologies include injuries to nerves, blood vessels, and bones, as well as deformities. In both cases, these can be the result from trauma or derived from other conditions, such as rheumatoid arthritis. These may include:
The diagnostic assessment and treatment should be performed to a hand specialist like myself. I’m Dr. Emmanuel Ruíz and I have the training and detailed knowledge of anatomy to perform procedures such as:
- Diagnostic arthroscopy
- Ganglion excision
- Total wrist prosthetic replacement
- Distal radioulnar joint replacement
Ganglion
Ganglions or synovial cysts are benign tumors that form on the back of the hand over the covering of its tendons or in the final joint of the fingers. A ganglion is filled with synovial fluid, with a gelatinous consistency (thick and transparent).
Although the reason for their development is not fully understood, they are believed to be related to previous trauma and, in some cases, arthritis. They typically appear spontaneously in individuals between the ages of 20 and 50 and often affect women more than men.
Symptoms
Typically, a ganglion does not present symptoms other than a change in appearance. However, some ganglions may cause discomfort, especially when associated with worn joints or certain activities. A ganglion can change in size over time, enlarging or shrinking and even disappearing on its own. People often describe ganglions as having a lump on the wrist that hurts.
Diagnosis and Treatment
A physical examination is performed, and the known appearance of the ganglion is assessed. To rule out other types of tumors, transillumination is performed in the office to demonstrate that the mass is composed of fluid. To confirm the diagnosis of a ganglion, imaging studies such as ultrasound or MRI are conducted.
The treatment depends on the symptoms presented. When it causes no discomfort, observation is recommended, and in some cases, cyst removal is advised. Sometimes, the cyst is removed by aspirating the synovial fluid; however, due to its recurrence, surgical removal is often chosen. Depending on its location, open techniques such as wrist surgery or wrist arthroscopy may be used.
If you are looking for where to have a synovial cyst removed in Monterrey, feel free to set an appointment with me. I’m Dr. Emmanuel Ruíz and I’m always available to help you!
Examples of tendinopathies and sports injuries include:
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Tendinopathies and sports injuries in the tendons are conditions that occur in areas where tendon compression can occur, such as when passing through a tunnel or pulley, or due to repetitive or sports activities, leading to inflammation and pain.
Examples of tendinopathies and sports injuries include:
- DeQuervain’s Tenosynovitis: Involving the tendons of the first extensor compartment of the hand, causing pain with thumb movements.
- Trigger Finger: A common disorder among arthritis and diabetes patients, involving the locking of a finger caused by tendon inflammation.
- Intersection Syndrome: An injury caused by overuse of tendons passing through the back of the hand, causing inflammation and pain in the area.
- Tennis Elbow: Involves inflammation of the tendons and/or muscles responsible for bending the hand backward, opposite the palm.
- Golfer’s Elbow: Inflammation of the tendons of the muscle involved in flexing the palm toward the wrist.
Tendinopathies present with inflammation, pain, clicking, or joint locking in the affected hand. The primary treatment involves managing pain and inflammation with oral medications. In some cases, local steroid injections may be necessary, and in more advanced or severe cases, surgery may be required.
DeQuervain’s Tenosynovitis
Stenosing tenosynovitis or DeQuervain’s tenosynovitis is the inflammation of two tendons that pass along the wrist to insert into the thumb and are responsible for moving the thumb outward. This syndrome primarily occurs in individuals with rheumatoid arthritis and first-time mothers who lift the baby by stretching their hands and using only their wrists.
Normally, ligaments pass through tunnels, allowing smooth and easy movement. However, with inflammation and increased volume, the area where these tunnels are located becomes sensitive and painful. Therefore, pain occurs on the wrist side of the thumb when rotating the wrist or engaging in activities that require hand grip.
Symptoms
The main symptom of DeQuervain’s Syndrome is continuous pain associated with certain movements, such as making a pinch with the thumb and index and other fingers, opening a door or jar, and even turning a key. There is sensitivity to palpation in the two tendons on the wrist side corresponding to the thumb.
In some cases, there is swelling or the presence of cysts on the wrist side of the thumb. Some patients report a snapping sensation related to inflammation around the tendons, which can cause irritation of superficial nerves responsible for the sensation of the thumb skin.
