Ganglion Cyst

What is a Ganglion Cyst?

A ganglion cyst is a lump at the hand and wrist that occurs near joints or tendons. It may be described as a mass, swelling, or bump. Ganglion cysts are common. They are frequently found in common locations and are often seen on the back of the wrist in the middle. They can also be near a finger joint.

What causes it?

A ganglion cyst can occur in patients of all ages. While the cause of ganglion cysts is unknown, the cysts may form in the presence of joint or tendon irritation, arthritis, mechanical changes, or injury.

Signs and symptoms

Symptoms of a ganglion cyst can include:

• A soft bump or mass that changes size but doesn’t move.
• Swelling that may appear over time or suddenly.
• It may get smaller in size or even go away and come back.
• One large cyst or many smaller ones may develop, but they are usually connected by deeper tissue.
• Some degree of pain is possible, especially after acute or repetitive trauma, but many aren’t painful.
• Pain may be chronic and get worse with joint movement.
• When the cyst is connected to a tendon, you may feel a sense of weakness in the affected finger.

Treatment

Dr. Daniel Singer takes you step by step through a finger ganglion cyst excision surgical procedure

Non-Surgical

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 could disappear spontaneously. If the cyst becomes painful, limits activity, or is otherwise causing problems, several treatment options are available.

The different types of non-surgical treatment may include:

• Observation (doing nothing but keeping your doctor informed if things change)
• Splints and anti-inflammatory medication, which can decrease pain associated with certain activities.
• Aspiration: This is done to remove fluid from the cyst and decompress it. This requires placing a needle into the cyst, which can be performed in most office settings. Sometimes the fluid is so thick it doesn’t fill the syringe. Pressure can be applied to the cyst to force the fluid out of the cyst into the surrounding tissue under the skin. Aspiration can be done with or without ultrasound guidance. Recurrence of the cyst is common since the cyst wall, or sac, and stalk remain connected to the joint.

Surgical

If non-surgical options fail to provide relief, or if the cyst reoccurs, surgical alternatives are available. Surgery involves removing the cyst wall, fluid, and stalk. It may include removal of a portion of the joint capsule or tendon sheath. In the case of wrist ganglion cysts, both open and arthroscopic techniques usually yield good results. Surgical treatment is generally successful. Even with surgery the cyst can come back since we do not fully understand what causes them and there are no known preventions. If the ganglion cyst returns and does not hurt, it can be left alone. If it returns and hurts, it can be removed again. Dr. Singer will discuss the best treatment options for you and give medical advice specific to your condition.