A ganglion cyst is a lump around the hand and wrist that occurs adjacent to joints or tendons. Ganglion cysts are very common. They are most frequently found on back 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 (see Figure 2). Your ganglion cyst may be filled with a clear, gel-like fluid and resemble a water balloon on a stalk (see Figure 3). They may fluctuate in size, and some may eventually disappear completely. A ganglion cyst is not cancerous and will not spread to other areas.
A ganglion cyst can occur in patients of all ages. While their cause is unknown, the cysts may form in the presence of joint or tendon irritation, arthritis, mechanical changes, or injury.
Your ganglion cyst may or may not be painful. The cysts are typically oval or round and may be soft or very firm. Cysts at the base of the finger on the palm side are typically very firm, smaller than a pea-sized nodule, and are tender to applied pressure, such as when gripping.
Cysts at the far joint of the finger frequently have arthritis associated with them. At this end knuckle, the overlaying skin may become thin, and there may be a lengthwise groove in the fingernail just beyond the cyst.
The diagnosis is usually based on the location of the lump and its appearance. Light will often pass through these lumps, and this may assist in the diagnosis. Your physician may request x-rays in order to look for evidence of problems in adjacent joints.
Treatment for a ganglion cyst can often be non-surgical. In many cases, these cysts can simply be observed, especially if they are painless. Ganglion cysts frequently disappear spontaneously. If the cyst becomes painful, limits activity, or is otherwise unacceptable, several treatment options are available, including:
If non-surgical options fail to provide relief, or if the cyst reoccurs, surgical alternatives are available. Surgery involves removing the cyst and may include removal of a portion of the joint capsule or tendon sheath. In the case of wrist ganglion cysts, both traditional open and arthroscopic techniques usually yield good results. Surgical treatment is generally successful, although cysts may reoccur. Your hand surgeon will discuss the best treatment options for you.
© 2018 American Society for Surgery of the Hand
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