Ganglion Cyst?

[KyWoman]

Has anybody here ever experienced a ganglion growing out of fingers that had been sausage-swollen? When I was first diagnosed with PA last February, my fingers were swollen up like sausages, most notably the middle finger on my right hand. After getting the swelling down through various medications, many of which I'm still taking (MTX, Remicade), that middle finger refuses to straighten out. It's crooked. The doctor says that x-rays show no joint damage. So I'm wondering what could possibly be making this finger NOT STRAIGHTEN OUT. It's as stiff as a board, and it's bent at the first knuckle at a 45 degree angle that won't give (won't bend further as if to make a fist, or won't straighten out). It's becoming more and more difficult to type and I'm afraid it will eventually affect my job (I am a policy consultant for the Education division of a major insurance company) at which I do almost constant work using a computer keyboard. The possibility of a ganglion has been suggested to me by lay persons who have had ganglions but who have not ever heard of PA (we have a lot of educating to do, don't we?). Anyway, I was wondering if anybody here has ever heard of and/or experienced such a thing as a ganglion growing out of a finger joint, rendering it useless.

Do I need to see a hand surgeon???

[einna]

What you describe sounds more like a trigger finger which requires a hand surgeon.

Annie

[JodyGK]

I agree with Annie (as usual :D ), it sounds like a trigger finger, which is the tendon locking. Tendon issues don't show up on x-rays. PA often affects our tendons. A hand surgeon might try injections and/or splinting first, and if there's no relief, surgery.

There's lots of good info on trigger finger on the Internet. I Googled "trigger finger syndrome" and got a lot of hits. Hope you get relief for it soon.

Jody

[JesseLou]

Surgery for trigger finger is pretty simple, and the recuperation is a lot better than the trigger finger problem. Good Luck!

[Ihurt]

I worked for a Plastics and Hand reconstructive surgeon for 7 years. Triggerfinger is most common in the middle finger. Ganglions like the wrist-not fingers. They will probably start with injections of Kennilon (if memory serves me correctly). Good luck!

[krislin]

I am a long time "lurker" and have found the information here invaluable and very supportive. Your question and description of your problem hit home with me so I decided to come out of hiding to share my experience.

Since your xrays do not show any damage, it's unclear what the lump on your finger might be. Perhaps when the Dr. told you there is no damage, he meant no PA damage. Your description of the lump on your finger could be a mucous cyst. They tend to occur over the DIP joints (the end joints) of fingers with osteoarthritis. Appearance wise, they look like a ganglion. They are benign but could interfere with the mobility of your finger.

The other possibility as pointed out by the other folks here is that you have a trigger finger. It is much more common for the PIP (middle joint of your finger) rather than the DIP joint to be immobilized by trigger finger but that would depend on whether the tendon is getting stuck in your palm which is the most common or further up your finger.

The fact that your finger is permanently bent and my personal experience is what "triggered" this reply. Please get yourself to a hand surgeon ASAP. While neither a trigger finger or mucous cyst are in and of themselves dangerous or permanent conditions, it sounds like you may have developed a contracture in the soft tissues around the joint and that can become a permanent situation if not treated. The surgery to treat trigger finger is a piece of cake in comparison to treating a contracture. I'm sure the same would be true for the surgery for a mucous cyst.

I developed trigger finger without the typical locking described in all the literature. My main symptoms were pain that fluctuated between a mild aching discomfort to pain severe enough to make me wish I could just cut the finger off and be done with it along with a clicking sensation at the base of the finger. Following a major PA flare that included substantial swelling of my finger, I woke up one morning to find it permanently stuck in a bent position at both the PIP and DIP joints. Needless to say this was not very functional and interfered with every day activities. My problem is in the left pinky finger so I can only imagine how much more aggravating it must be to have a middle finger stuck in a bent position.

I had surgery to release my trigger finger early in December. The hand surgeon started treating the contracture mid November and I have been wearing a splint on my hand 14 to 18 hours a day since to gradually straighten my finger. It is a slow arduous process because overdoing the splinting to straighten the finger can result in a loss of the remaining ability to bend the finger.

I had to wait four months to see the hand surgeon so the contracture had lots of time to get "set". It's vital to get this treated ASAP because the longer your finger is stuck, the longer it will take to regain the mobility if it is possible to regain it at all. My hand surgeon took pictures of my hands for a presentation he is doing for the medical students because according to him, many physicians do not realize how common it is for people to develop a contractures from this seemingly "benign" condition. While the general population can quite often get full relief of trigger finger locking with cortisone injections, our PA complicates this and we require surgery more often than not to correct it.

I don't mean to alarm you but my experience has taught me not to take anything too lightly when it comes to my PA.

Linda

[RichJ]

hi linda,
sorry i can't help much but welcome to the p family. you have met some of the wonderful people on here and will find alot of great info. welcome and nice to meet you.

have a good night all

richard

[atmkd]

Almost invariably appear on the wrist either underneath or on top. With most of them appearing on the top side. The old school of thought was to bust the cyst with a book. Which sometimes does work and other times may cause more damage.

I personally had one appear on top of my right wrist after it was broken in karate class. My wife being a nurse I several times had her draw the fluid out with a rather large needle/ syringe. The fluid is thick and has the appearance of apple jelly.

Each time I had it drawn down it stayed away for several months. It did not hurt but was in a location that frequently pinched it which would hurt.

I ultimately had it removed surgically. After several years it came back, at which time out of frustration I whacked it with a book and it went away. Several times over the years it comes back and I'll whack it with a book and it will go away. I don't want to go the surgical route again because I lost some range of motion in my wrist from the surgery.

However if it is arthritic I would not recommend whacking it with a book.