What is it? Ganglion cysts are very common masses (lumps) that sometimes grow in the hand and wrist. The cysts are generally found on the top of the wrist, on the palm side of the wrist, the end joint of a finger (mucous cysts), and at the base of a finger. Ganglion cysts usually come from nearby joints or tendon sheaths. There is no specific cause. These cysts can be painful, especially when they first appear or with constant or strenuous use of the hand. Ganglions often change in size and may disappear completely. These cysts are not malignant (cancerous).
Diagnosis. The diagnosis of a ganglion cyst is usually based on where the cyst is and what it looks like. Your hand surgeon may recommend X-rays to rule out problems in nearby joints.
Treatment. Treatment of ganglion cysts may be simply watching for any changes. However, if the cyst is painful, limits activity, or its appearance is unacceptable to the patient, other treatment may be recommended. Treatment may include removing fluid from the cyst with a needle and/or the wearing of a splint to keep the hand or wrist from moving. If these nonsurgical treatments fail, surgery to remove the cyst may be recommended by your hand surgeon.
The goal of surgery is to remove the source of the cyst. This may require removal of a portion of the joint capsule or tendon sheath next to the ganglion. If the ganglion is removed from the wrist a splint may be recommended following surgery. Some patients may feel tenderness, discomfort, and swelling at the site of their surgery a little longer than others, but full activity can be resumed once comfort permits. While surgery offers the best success in removing ganglions, these cysts may return.
• Diagram 1
Ganglion dorsum of wrist and end joint of the finger (mucous cyst).
• Diagram 2
Ganglions, palmar wrist and base of finger.
• Diagram 3
Cross section of wrist showing root of ganglion
Copyright © American Society for Surgery of the Hand 2001.