A ganglion cyst is a fluid filled lump or mass along the hand or wrist. They are benign in nature and are very common occurrences. Most do not cause any symptoms and therefore do not require any treatment. Some cysts disappear on their own while others do become larger in size and become painful. The true cause of a ganglion cyst is unknown. They occur more in women than men and generally between the early teenage years until the early 40’s. Some believe that ganglion cysts arise as a result of injury to the soft tissues surrounding a joint. A defect in the joint capsule or tendon sheath has also been postulated as an underlying cause.
Clinically, ganglion cysts are diagnosed by physical examination. Most ganglion cysts have characteristic appearance that make them easily recognizable. An x-ray may be ordered to evaluate for any bony abnormalities or arthritic changes. If there is no concern for a tumor (malignant), there are several different treatment options.
As previously mentioned, some cysts do not require treatment as they do not always cause pain or limit activity. Watching and waiting for the cyst to disappear is an option for some. In other cases, an orthopaedic surgeon will recommend trying to drain the cyst (aspirate) and inject a corticosteroid to reduce inflammation. Unfortunately, not all cysts are able to be aspirated. Some cysts will re-form even after being drained. A wrist brace may be recommended to alleviate pain if the cyst is pushing on a nerve.
In cases where non-surgical methods fail, surgery may be recommended to remove a ganglion cyst. This is performed on an outpatient basis. The procedure involves removing not only the cyst, but also a part of the affected tendon sheath or joint tissue. Reoccurrence of a cyst is possible even after surgery.
Those that interfere with activity or cause pain/discomfort.