Ganglion cyst around Shoulder joint

Ganglion Cyst

A ganglion cyst can occur in any joint, including the shoulder. A ganglion cyst is a fluid-filled mass that lies beneath the skin or muscle near a tendon or joint. Ganglion cysts often form within the body’s deep tissue as one large cyst or a cluster of smaller cysts connected by a common stalk. A paralabral cyst is a form of a ganglion cyst that is located near the shoulder’s socket (glenoid), commonly caused by a labral tear. Patients living in the greater geo communities suffering from any form of a shoulder cyst are encouraged to contact Dr. Rahul Bade. As an orthopedic surgeon and shoulder specialist,takes great pride in treating patients with a shoulder abnormality and returning them to an active, healthy lifestyle.

Symptoms of a Shoulder Ganglion Cyst

Many ganglion cysts associated with the shoulder joint cause patients to experience zero pain or discomfort. In cases of a paralabral cyst, patients may experience pain from the labral tear but not the cyst itself. A cyst may become large enough in certain patients to compress on surrounding nerves of the shoulder joint, causing pain and weakness of the muscles supplied by the nerve.  When a nerve is acutely compressed, there can be significant shoulder pain followed by shoulder weakness and muscle atrophy.

The exact cause of a ganglion cyst is unknown, but many paralabral cysts develop after a labral tear. Many medical professionals believe a ganglion cyst is formed when the natural joint lubricating fluid, known as synovial fluid, leaks or is pushed out into the common stalk, causing a fluid-filled sac to form. Many ganglion and paralabral cysts increase and decrease in size. In certain patients, the cyst will even disappear only to reappear at another time.

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Diagnosis of a Shoulder Ganglion Cyst

In order to diagnose a shoulder ganglion cyst or a paralabral cyst, Dr. Rahul Bade will perform a thorough medical review and physical examination. An MRI is often utilized to detect the presence and location of a cyst and any associated labral pathology.  An ultrasound may be performed to determine if the mass is solid or fluid-filled, as well as to determine if a blood vessel or artery is causing the cyst to form.

Treatment of a Shoulder Ganglion Cyst

Non-Surgical

Non-surgical treatment is the most common treatment approach in patients with ganglion cysts. If the ganglion cyst is not causing pain, Dr. Rahul Bade may recommend no treatment but to watch the mass closely. If the cyst causes shoulder pain, weakness or discomfort, Dr. Rahul Bade will advise relatively rest, exercises, and physical therapy.  He may also recommend aspirating the cyst.

Surgical

Dr. Rahul Bade may recommend an arthroscopic surgical procedure to remove the ganglion cyst if there is acute nerve compression and nerve in jury, or if other treatment options have failed. Surgical treatment for paralabral cysts involves an arthroscopic repair of the labral tear, as well as decompression of the nerve and drainage of the cyst. When the cyst is superficial, he will utilize a local or regional anesthesia, make a small incision over the ganglion cyst and common stalk and remove the fluid-filled sac completely.

Abstract

Ganglion cysts of the shoulder and concomitant suprascapular nerve compression should be considered in the differential diagnosis of shoulder pain. They are associated commonly with labral tears, most commonly SLAP lesions. MRI has become commonplace in evaluating shoulder pain and has led to the increased awareness of shoulder cysts. MRI accurately demonstrates the size and location of ganglions, which is critical when planning surgical intervention. It also has shown the frequent association of intra-articular pathology with these cysts. Despite that MRI can detect atrophy, the diagnosis of suprascapular nerve compression can be confirmed only by EMG/NCS, because the presence of a cyst does not necessarily mean the nerve is compressed. Likewise, a positive EMG does not confirm that the compression is caused by a ganglion cyst. EMG/NCVs are necessary for confirming the diagnosis and evaluating nerve and muscle function. A trial of nonoperative management is warranted; however, this is associated with a high failure rate. Aspiration techniques are successful for decompression of the cysts and initial pain relief; however, the intra-articular pathology is not addressed and there is a higher rate of recurrence.

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