Topic: Ganglion?

I've recently noticed a couple of lumps (for lack of better description) developing in the palm of my left hand .  They are right in the middle of my palm, sort of where tendons operating 2 middle fingers run.  Under the skin.  They are not at all painful, although I have begun to notice some tingling sensation in the middle fingers of that hand after several hours of playing/practicing.  I suspect a Ganglion Cyst developing, is the general consensus to see a physician about this before it gets bigger?  Hand Specialist (we have a local one who is a former bassoonist and would certainly be sympathetic to working around my schedule if surgery is required)??  Thanks

-Frank Watson
Greenville(SC),  Spartanburg Symphonies

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Re: Ganglion?

You may have the beginnings of Dupuytrens Contracture, a thickening of the small tendon fibres which run down the fingers.  It is very common and you can read a lot about it online.  Most hand specialists who deal with Dupuytrens take the "if it ain't broke, don't fix it" attitude towards this situation because any trauma to the hand tends to exacerbate the condition, and most procedures, including surgery, are definitely trauma.  The condition does not get better, unfortunately, and in its last stages the affected fingers are unable to straighten.  But this result takes years to happen, and surgery is usually ultimately called for to release the tightness of the tendon(s).

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Re: Ganglion?

Frank, it's likely that you're describing the nodules of Dupuytren's 'process.' Ganglions on the flexor tendon sheaths in the palm are usually at the outermost area of the palm and rarely more than 3-4 mm in diameter -- also, they're deeper under the skin. Dupuytren's affects the connective tissues that hold the palm skin down to the deeper tissues -- tendons are not affected. Surgery is indicated when the tissue changes produce contractures of the fingers severe enough to interfere with daily activities, including making music.

Please look at my article in the 2003 Double Reed for more information: Ask the doctor: Dupuytren’s “disease.” The Double Reed
2003;26(1):100-101.

Bill

Dr. Bill Dawson, bassoonist and teacher
IDRS medical consultant
Past President, Performing Arts Medicine Assoc.
Author of "Fit as a Fiddle: The Musician's Guide to Playing Healthy"

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Re: Ganglion?

Exactly.  I shouldn't have used the word "tendon."  You're quite right.

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