Ganglion Cyst

A ganglion cyst is the most common soft tissue mass of the hand and wrist. The cyst is a collection of fluid that is gelatinous in nature. These cysts can be very small or enlarge to become unsightly. They are not cancerous. Some cysts feel quite hard and may be mistaken for a bony prominence. Ganglion cysts most commonly arise from the back of the wrist. Cyst may occur in other locations.

The exact cause of a ganglion cyst is not known. It may be related to trauma such as a fall on an outstretched hand although often patients have no prior history of injury. The cyst may also be due to degeneration of the adjacent tissue lining a joint or tendon sheath.

A physician should evaluate any mass that is persistent. Often a ganglion cyst can be diagnosed after the patient describes their symptoms to the physician and the cyst is examined. An ultra sound or MRI can be used to help confirm the diagnosis. Aspirating the gelatinous material consistent with a ganglion cyst is diagnostic.

The old wives tale that the cyst is burst by hitting it with a bible is not performed. The cyst is observed when it is small and causes no significant discomfort. Splints and pain medication may be helpful in limiting symptoms. An aspiration, which involves pulling the fluid out of the cyst with a needle, can be diagnostic and therapeutic. Approximately 50 percent of cysts will not recur after aspiration. The diagnosis is confirmed if the typical gelatinous material is obtained.

If the cyst is painful or the size of the prominence is bothersome removal of the cyst can be considered. The cyst may recur in approximately 10 percent of cases despite surgical excision. In addition surgical treatment may result in joint stiffness which underscores the importance of the exercise program after surgery. The cyst on the palm side of the wrist is adjacent to the radial artery that is at risk. The risk of an infection postoperatively is low.