What is a ganglion cyst?
Ganglion cysts are the most common swelling in the hand and wrist. They contain a thick clear liquid called synovial fluid, which is the body’s lubricant in joints and in the tunnels which the tendons run. Although ganglion cysts can arise from any joint or tendon tunnel, there are 4 common locations in the hand and wrist – the back of the wrist, the front of the wrist, at the base of the thumb and at the base of the finger.
What is the cause?
Ganglion cysts arise when the synovial fluid leaks out of a joint or tendon tunnel and forms a swelling under the skin. The cause of the leak is generally unknown.
What are the symptoms?
A swelling or lump appears. This may or may not be painful.
How is the diagnosis made?
The diagnosis is made on clinical grounds, as these lumps are characteristic and found in specific locations. Drawing the fluid out of the cyst with a needle confirms the diagnosis. If the diagnosis is unclear, then a scan may confirm diagnosis.
What is the treatment?
Most ganglion cysts can be safely left alone. Many will resolve spontaneously over the course of several years and many cause no problems.
If the ganglion cyst is large, then aspiration of the fluid within the cyst may be recommended. This is usually done with a needle, and under local anaesthetic.
The dorsal wrist ganglion is particularly common in older children and young adults. It is often self limiting and is harmless. If large and painful, it is best treated with aspiration as required.
Surgical excision is rarely indicated, as the scar can produce persistent pain and tenderness. The risk of surgery is general thought to outweigh any benefit.
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