Ganglion Cysts
What are ganglion cysts?
Ganglion cysts are very common lumps within the hand and wrist that
occur adjacent to joints or tendons. The most common locations are
the top of the wrist (see Figure 1), the palm side of the wrist, the
base of the finger on the palm side, and the top of the end joint of the
finger. The ganglion cyst often resembles a water balloon on a
stalk (see Figure 2), and is filled with clear fluid or gel. The cause
of these cysts is unknown although they may form in the presence of
joint or tendon irritation or mechanical changes. These cysts may change
in size or even disappear completely, and they may or may not be
painful. These cysts are not cancerous and will not spread to
other areas.
How are ganglion cysts diagnosed?
The diagnosis is usually based on the location of the lump and its
clinical appearance. They are usually oval or round and may be soft or
very firm. Cysts at the base of the finger on the palm side are
typically a very firm, pea-sized nodule that is tender to applied
pressure, such as when gripping. Light will often pass through these
lumps (trans-illumination) and this can assist in the diagnosis. Your
physician may request x-rays in order to investigate problems in
adjacent joints; cysts at the end joint of the finger frequently have an
arthritic bone spur associated with them.
What are the treatment options for ganglion cysts?
Treatment can often be non-surgical. In many cases, these cysts
can simply be observed, especially if they are painless. If the cyst
becomes painful, limits activity, or is cosmetically unacceptable, other
treatment options are available. The use of splints and
anti-inflammatory medication can be prescribed in order to decrease pain
associated with activities. An aspiration can be performed to remove the
fluid from the cyst and decompress it. This requires placing a
needle into the cyst, which can be performed in most office
settings. If non-surgical options fail to provide relief or if the
cyst recurs, surgical alternatives are available. Surgery involves
removing the cyst along with a portion of the joint capsule or tendon
sheath (see Figure 3). In the case of wrist ganglion cysts, both
traditional open and arthroscopic techniques may yield good results.
Surgical treatment is generally successful although cysts may recur.
Your surgeon will discuss the best treatment options for you.
Figure 1: Ganglion top side (dorsum) wrist
Figure 2: Ganglion end joint of finger (mucous
cyst)
Figure 3: Cross-section of wrist showing stalk
(or root) of ganglion.
© 2006 American Society for Surgery of the Hand
Developed by the ASSH Public Education Committee
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