What is a hygroma?
The movements of our arms, legs and all other parts of the body occur in the joints – the joints of the bones. To reduce friction in the joint, nature came up with this: the ends of the bones in the joint are covered with smooth cartilage, and between the cartilage is the articular or synovial fluid. The smooth friction of the cartilage in a fluid medium promotes movement. Along the edge of the cartilage, a shell is attached to the bones – the joint capsule – which does not allow the synovial fluid to leak out. Synovial fluid is water in which a small amount of salts, proteins and carbohydrates are dissolved. It is formed, updated and absorbed by the joint capsule, or otherwise – by the synovial membrane.
Another common site of friction in the body is the long tendons that muscles use to pull on bones as they move. These tendons are also enclosed in a synovial sheath – the so-called “tendon sheaths”, and the sheath also contains synovial fluid.
If the pressure in the joint is constantly increased, and the capsule in some place is weak and thinned, then in this place it can stretch in the form of a bag connected with the rest of the capsule with a thin neck. In this sac, the normal circulation of the synovial fluid is disrupted, water is intensively absorbed from it, and as a result, a sac is obtained from the synovial membrane filled with jelly. This is the hygroma.
Thus, a hygroma is a benign formation, limited by a capsule, which is filled with a clear liquid. Less commonly, hygromas “string off” from the sheaths of the tendons, extremely rarely they are even inside the skull.
Are hygromas dangerous?
Most often, hygromas are safe: they do not degenerate into cancer, they do not suppurate, they do not hurt. The exception is rare cases if a large hygroma presses on the nerves or vessels adjacent to it, or if the hygroma is located inside the skull. Most often, the hygroma is only a cosmetic defect, and sometimes it is very noticeable, but it can also interfere with putting on shoes or a bracelet. It must be remembered that hygroma is always secondary, that the cause of its appearance is the ill health of the joint from which it grew. And here an experienced surgeon and / or traumatologist-orthopedist will help to solve the problem.
Why do they appear?
In order for a hygroma to appear, a combination of two factors is enough: constantly increased pressure in the joint and local weakness of its capsule. Weakness of the joint capsule may be caused by trauma or previous inflammation, or it may be a sign of congenital weakness of the connective tissue. Moreover, the weakness of the connective tissue is easy to identify: it can also manifest itself as myopia, varicose veins, hemorrhoids, flat feet – this condition is called connective tissue dysplasia, this is not a disease, but a feature of the body.
Constant high pressure is characteristic of the joints of the legs, which carry the main load of the body: ankle and knee joints (Baker’s cyst – posterior hygroma of the knee joint – one of the favorite locations for hygromas), as well as for the wrist joint and joints of the hand – a consequence of writing, working on the keyboard , playing the piano, carrying bags and other long-term stress on the arm.
Do they need to be removed?
Intracranial hygromas, as well as hygromas that cause compression of surrounding structures, must be removed. Fortunately, this rarely happens. Most often, hygromas are removed at the request of their owner, who, in turn, must first consult with a specialist – if they interfere, for example, with wearing a watch or cause cosmetic discomfort.
Which doctor should I contact to remove the hygroma?
Hygroma is a formed sac from the synovial membrane. Unfortunately, the stretched synovium will not shrink back. There is a method of “crushing” the hygroma. It is described in the novel by Mario Puzo “The Godfather” – there the doctor hits the hygroma on the patient’s arm with a thick book, and she disappears. It happens like this: upon impact, the jelly filling the hygroma enters the joint and dissolves in its synovial fluid, and the hygroma is emptied and “falls off”. Unfortunately, this method gives a temporary effect – the hygroma shell will again produce synovial fluid, water will be sucked out of the fluid again, a jelly will form, and the hygroma will reappear. Therefore, unfortunately, there are no alternatives to removing the hygroma. Hygromas are removed by surgeons or orthopedic traumatologists. Turning to doctors of other specialties is meaningless, and turning to traditional medicine is also dangerous.
The consequences of inaction, or when it is better not to touch the hygroma
If the hygroma is not located inside the skull and does not compress the surrounding structures, inaction with the hygroma is relatively safe. Why relatively? Because it signals a malfunction in the joint from which it grows. If you do not remove the hygroma, then you need to examine the joint, are there any other violations in it? Various measures may be necessary: with hygromas of the knee or ankle joint, weight loss may be relevant, with hygromas of the hand, selection of an emphasis for working with a computer mouse, etc. It may also be relevant to check visual acuity, examine a phlebologist, proctologist and orthopedist to identify other manifestations of connective tissue weakness.
It’s important to know!
In order not to miss other serious disorders that may not be as obvious as hygroma, before removing the hygroma, it is necessary to comprehensively examine the joint from which it grows.
Since the hygroma is associated with the joint, removing it under local anesthesia can be uncomfortable – anesthesia is preferable. After removal, fixation of the joint is necessary so that the hygroma does not grow again.
Photo: Vostock Photo
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