Ganglions Are Your Garden Weeds, Technique Review, & Evidence on Ganglion Recurrence

Managing ganglions feels like a never-ending battle against weeds. We can try aspiration, excision, or simply watch and wait. Yet, much like weeds, ganglions have a way of reappearing, sometimes in the same spot, sometimes elsewhere. Our approaches vary as widely as opinions on weed control — some dig deep with excision, others opt for the less invasive route of aspiration, and some prefer to leave them alone, knowing they can be messy and unpredictable.

For patients, ganglions are just as frustrating. They bring discomfort and confusion, especially when different doctors give different advice. One may say, “Leave it alone,” while another suggests, “Let’s remove it.” This inconsistency can make patients feel lost in a garden of conflicting opinions.

Ganglions, like weeds, are a reminder of the inherent uncertainty in our practice. They show us that not every problem has a straightforward solution

So, the next time a ganglion pops up, think of it as a part of the garden's natural state. It's not about eradicating every weed but about managing the garden in a way that keeps the patient satisfied with their care.

Lot of Love,
P'Fella ❤️

In 2010, Paramhans introduced the double dart technique: using concurrent 16-gauge (for aspiration) and 24-gauge needles (for triamcinolone acetonide injection) in the ganglion. This is visualised below. 

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In case you've missed out, here's a reminder to check out our fresh articles, clinical cases, and surgical techniques.

Read below for an overview of our clinical case on Ganglion Cysts.

Ganglion Cyst - Clinical Scenario

Objectives

1. Clinical diagnosis of a ganglion.
2. Describe the anatomical origins of ganglions.
3. Be aware of different aetiological theories.
4. Provide justified investigations to the patient.
5. Joint decision-making process for treatment options.

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