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Ganglion Cysts of the Hand
手部腱鞘囊腫
Overview（概述）
A ganglion cyst is a fluid-filled sac that forms as a herniation from a joint capsule or tendon sheath. The sac is attached to the joint or tendon sheath by a "stalk" that allows fluid to move into the pouch from the joint or sheath. The stalk functions as a valve and often limits fluid drainage out of the cyst, allowing the cyst to increase - but not decrease - in size. In some cases the stalk functions as a two-way valve, allowing fluid to travel in both directions. This can enable the cyst to increase and decrease in size based on activities.
腱鞘囊腫是一種充滿液體的囊，由關節囊或腱鞘向外疝出形成。囊有「蒂」與關節或腱鞘相連，允許液體從關節或腱鞘進入囊中。蒂相當於閥門，通常限制液體從囊腫中流出，允許囊腫增大，但不能縮小。在某些情況下，蒂起到雙向閥門的作用，允許液體沿雙向流動。這可以使囊腫隨活動而增大或縮小。
Causes（原因）
The exact cause of ganglion cysts is unknown. They are believed to result from weakness of the joint capsule, ligaments or tendon sheath, which may be inherited or may be caused by arthritis, joint inflammation or trauma.
腱鞘囊腫的確切原因尚不清楚。它們被認為是由關節囊、韌帶或腱鞘上薄弱引起的，這些薄弱可能是遺傳的或可能是由關節炎、關節炎症或創傷引起的。
Where They Occur（好發部位）
Ganglion cysts can develop at any joint in the hand or wrist. They are most commonly found at the center of the back of the wrist. They are also commonly found on the palm side of the hand near the base of the fingers and the thumb side of the wrist, and on the back of the finger near the nail.
腱鞘囊腫可發生在手或腕關節的某些關節處，最常見於腕背的中心，也常見於靠近手指根部的手掌側，和腕關節的拇指側，以及手指背部靠近指甲處。
Symptoms（症狀）
A ganglion cyst typically forms a firm bump under the skin. The bump may be large and obvious, or it may be very small and felt only with deep pressure. The cyst may increase in size during periods of increased activity, and then decrease in size with rest. Although most cysts do not cause pain, small cysts on the top of the hand can cause pain with wrist extension activities such as yoga or push-ups, and cysts on the palm side of the wrist may press painfully on the radial artery. Cysts in the fingers may cause pain when grasping objects.
腱鞘囊腫通常在皮膚下形成硬塊。腫塊可能很大，很明顯，也可能很小，只有在深壓下才能感覺到。囊腫可能在活動期間增大，然後隨著休息而縮小。雖然大多數囊腫不會引起疼痛，但手背的小囊腫會因手腕伸展活動如瑜伽或伏地挺身而引起疼痛，而手腕掌側的囊腫會壓迫橈動脈引起疼痛。手指中的囊腫可能會在抓握物體時引起疼痛。
Treatment（治療）
Not all cysts require treatment. Those that do not cause pain or limited motion can simply be observed - they may go away over time, especially in children. A painful or bothersome cyst can be drained with a needle (called aspiration), and a steroid can then be injected into the capsule or tendon sheath to decrease inflammation and decrease risk of recurrence. A cyst on the palm side of the wrist near the thumb often cannot be aspirated because of its proximity to the radial artery. For recurrent cysts or cysts on the palm side of the wrist or hand, surgical removal may be needed.
並非所有囊腫都需要治療。那些沒有引起疼痛或運動受限的症狀可以作簡單的觀察，有些可能過一段時間自然消失，尤其是兒童。疼痛或令人討厭的囊腫可以用針穿刺引流（稱為抽吸），然後可以將類固醇注射到關節囊或腱鞘，以減少炎症和減少復發的風險。在手腕掌側靠近拇指的囊腫由於靠近橈動脈常常不能被抽吸。對於復發的囊腫或在手和腕關節掌側的囊腫，可能需要手術切除。
（胡佰文 譯）
相關閱讀：
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中英文字幕：腱鞘囊腫切除術（Ganglion Cyst Removal）
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