Ganglion Cysts

What are a Ganglion Cysts?

Ganglion Cysts are the most common soft tissue mass or lump in the hand. Ganglions are balloon like lumps filled with a jellylike fluid. These lumps are an outpouching of fluid from the adjacent joint or tendon sheath.

There is usually no obvious cause, but sometimes ganglions may be a result of arthritis or injury. Ganglions can be painful, especially when they first appear or after strenuous use. Ganglions often fluctuate in size and may disappear naturally. Ganglions are harmless and are not malignant (cancer).

Diagnosis:

The diagnosis is usually based on the location of the lump and its appearance.

  1. Dorsal wrist ganglions: These ganglions arise from the back of the wrist from the underlying ligament (scapholunate ligament).
  2. Volar wrist ganglion: These ganglions arise from the palm side of the wrist joint.
  3. Mucous cysts arise on the back of the finger near the nail.

Treatment:

Treatment may be non surgical. Once the diagnosis is confirmed, observation may be indicated. If a cyst becomes painful, or limits activity then splints and anti-inflammatory medications may be useful. Other treatments may include aspiration or surgical excision. The goal of surgery is to remove the source of the cyst. This may require the removal of a portion of the joint capsule or tendon sheath adjacent to the ganglion. 

While surgery offers the best rate of success in removing ganglions, these cysts may recur or return. 

Mucous cysts need careful considerations if they are large in size, or the lesion is discharging or leaking. Surgery may be required in this instance and a hand surgical opinion is recommended.