Ask a Doctor: What is the Lump on My Wrist?

What is this lump on the back of my wrist?

The most common cause of a lump on the back of the wrist is a ganglion cyst. This is the most common tumor in the hand and wrist. Ganglion cysts are seen frequently in the wrist but can occur at the base of the fingers or around the finger joints. The cyst is typically filled with fluid, and it will feel firm. Ganglion cysts can be asymptomatic or cause a dull ache with certain activities such as pushups or planks. There are several treatment options for a ganglion cyst, including observation (doing nothing), aspiration (puncturing with a needle), or surgically removing it. The best way to confirm the diagnosis is to make an appointment to see your local hand surgeon.

I have had a slow growing lump in my hand for the past 5 years, should I get it checked out?

Any lump or bump in the hand or wrist is considered a tumor. The term “tumor” does not necessarily mean it is malignant or that it is a cancer. All it means is that there is an abnormal growth. In fact, most hand and wrist tumors are benign (not cancer). More than likely, your slow growing lump is a benign growth. It could be many diagnoses including fibroma, giant cell tumor of tendon sheath, lipoma, or even a ganglion cyst.
However, there are cancerous growths that can also occur in the hand and wrist. Even cancerous growths can be slow growing and painless. These types of tumors are called sarcomas and can rarely occur in the hand. Even if the lump is painless, if you have noticed changes over the years, it should be evaluated by your doctor. As part of the work up, your doctor may proceed with x-rays and even other studies such as an ultrasound or MRI. If your doctor is concerned that the tumor in your hand or wrist may be cancerous, he or she may recommend a biopsy or referral to a sarcoma specialist.

I broke my finger and the urgent care doctor said there was a tumor in my bone. What should I do?

Most likely, you have a benign (non-cancerous) tumor within the bone called an enchondroma. Enchondromas are the most common bone tumor within the hand. It is an abnormal growth of cartilage within the bone that can make the bone weak and prone to fracture. Most enchondroma are found incidentally (by accident) after a routine x-ray of the hand. If the enchondroma is small and painless, it usually can be treated with observation. If the enchondroma is larger, it may become painful and even weaken the bone to the point that it can break. In these cases, surgery is most often required to scrape out the tumor, strengthen the bone, and fix the break if needed.

I am developing a dark stripe underneath my nail. What is going on?

There are several reasons for skin darkening underneath the nail (melanonychia). Occasionally it can occur after an injury or infection. It can also be more prevalent in darker-skinned individuals (in this case it can occur in multiple nails). Certain medications can cause melanonychia and it also be associated with pregnancy.
Melanoma (a type of skin cancer) can also show up as a dark stripe underneath the nail. Melanoma of the hand or nail is treated with a small procedure or surgery. So, if you are experiencing darkening underneath the nail, it is important to be evaluated by a hand surgeon or dermatologist.

I have a lump in my palm and my finger is getting more bent. Can this be fixed?

Most likely you have a Dupuytren’s contracture. This is a painless condition that usually starts with lumps or knots of tissue in the palm. These lumps can progress into a cord that can pull the fingers into a bent position. The condition can worsen over time and can lead to functional problems using your hand. While the cause is unknown, Dupuytren’s contracture can have a genetic component and can run in families. Additionally, people of Northern European descent are a higher risk for this diagnosis. Other risk factors may include male gender, age over 50, diabetes, and alcohol and tobacco use.
Treatment is geared toward improving the range of motion of the affected finger (or fingers). Treatment can range from in office injections or needling procedures, to outpatient surgery to remove the cords.
It is important to distinguish this diagnosis from rare occurrence of malignant growths in the palm that may mimic Dupuytren’s nodules such as epithelioid sarcoma.

Learn more about wrist and hand tumors at www.HandCare.org.

Dr. Talia R. Chapman is an Assistant Attending Orthopedic Surgeon at Hospital for Special Surgery and Memorial Sloan Kettering Cancer Center in New York. Her focus is the treatment of hand, wrist, forearm, and elbow injuries as well as fractures, degenerative conditions and benign and malignant tumors. At Memorial Sloan Kettering Cancer Center, she specializes in the treatment of upper extremity bone and soft tissue tumors as well as limb salvage and reconstructive procedures. Dr. Chapman completed her orthopedic surgery residency training at Thomas Jefferson University Hospital in Philadelphia. She received fellowship training in hand and upper extremity surgery at HSS and additional fellowship training in orthopedic oncology at Memorial Sloan Kettering Cancer Center.