Ganglion Cyst

What is ganglion cyst

Ganglion cysts are among the most common benign (noncancerous) soft-tissue masses or lumps in the hand. Ganglion cyst most often occurs on the wrist and hand adjacent to joints or tendons 1). The most common locations are the top of the wrist (see Figure 1), the palm side of the wrist, the base of the finger on the palm side, and the top of the end joint of the finger. They also may occur in the ankles and feet. Ganglion cysts are typically round or oval. The ganglion cyst often resembles a water balloon on a stalk and is filled with clear fluid or jellylike fluid.

Ganglion cysts vary in size, may quickly get smaller and larger and may even disappear completely, only to return later.

Many ganglion cysts do not require treatment.

Small ganglion cysts can be pea-sized, while larger ones can be around an inch (2.5 centimeters) in diameter. Ganglion cysts can be painful if they press on a nearby nerve. Their location can sometimes interfere with joint movement.

If your ganglion cyst is causing you problems, your doctor may suggest trying to drain the cyst with a needle. Removing the cyst surgically also is an option. But if you have no symptoms, no treatment is necessary. In many cases, the cysts go away on their own.

Are ganglion cysts dangerous ?

Ganglion cysts are not cancerous and will not spread to other areas.

Ganglion cysts are often painless, requiring no treatment.

Are ganglion cysts painful ?

Ganglion cysts may change in size or even disappear completely, and they may or may not be painful.

Figure 1. Ganglion Cyst 

Ganglion Cyst

How do ganglion cysts form ?

Although the exact cause of ganglion cysts is unknown, they may arise from trauma—whether a single event or repetitive microtrauma. Although they may form in the presence of joint or tendon irritation or mechanical changes.

Ganglion cysts occur in patients of all ages, but they are most common in younger people between the ages of 15 and 40 years, and women are more likely to be affected than men. Ganglion cysts are also common among gymnasts, who repeatedly apply stress to the wrist.

Ganglion cysts that develop at the end joint of a finger — also known as mucous cysts — are typically associated with arthritis in the finger joint, and are more
common in women between the ages of 40 and 70 years 2).

Risk factors for ganglion cysts

Factors that may increase your risk of ganglion cysts include:

  • Your sex and age. Ganglion cysts can develop in anyone, but they most commonly occur in women between the ages of 20 and 40.
  • Osteoarthritis (degenerative joint disease). People who have wear-and-tear arthritis in the finger joints closest to their fingernails are at higher risk of developing ganglion cysts near those joints.
  • Joint or tendon injury. Joints or tendons that have been injured in the past are more likely to develop ganglion cysts.

Symptoms of a ganglion cyst

The diagnosis is usually based on the location of the lump and its appearance. Ganglion cysts are usually oval or round and may be soft or very hard.

A ganglion cyst is associated with one or more of the following symptoms:

  • A noticeable lump—often this is the only symptom experienced
  • Tingling or burning, if the cyst is touching a nerve that pass through the joint.
  • Dull pain or ache, which may indicate the cyst is pressing against a tendon or joint
  • Difficulty wearing shoes due to irritation between the lump and the shoe

How is Ganglion cyst Diagnosed ?

To diagnose a ganglion cyst, your doctor will perform a thorough examination of the hand or the area where the ganglion cyst is located. The lump will be visually apparent, and, when pressed in a certain way, it should move freely underneath the skin. Sometimes the surgeon will shine a light through the cyst or remove a small amount of fluid from the cyst for evaluation. Your doctor may take an x-ray, and in some cases, additional imaging studies may be ordered.

Ganglion cysts treatment

Nonsurgical Treatment

Initial treatment of a ganglion cyst is not surgical.

There are various options for treating a ganglion cyst on the foot:

  • Monitoring but no treatment. If the cyst causes no pain and does not interfere with function, the surgeon may decide it is best to carefully watch the cyst over a period of time. Because the ganglion cyst is not cancerous and may disappear in time.
  • Immobilization. Activity ofen causes the ganglion to increase in size and also increases pressure on nerves, causing pain. A wrist brace or splint may relieve symptoms and cause the ganglion to decrease in size. As pain decreases, your doctor may prescribe exercises to strengthen the wrist and improve range of motion.
  • Shoe modifications. Wearing shoes that do not rub the cyst or cause irritation may be advised. In addition, placing a pad inside the shoe may help reduce pressure against the cyst.
  • Aspiration and injection. This technique involves draining the fluid and then injecting a steroid medication into the mass. More than one session may be needed. Although this approach is successful in some cases, in many others, the cyst returns. Aspiration frequently fails to eliminate the ganglion because the “root” or connection to the joint or tendon sheath is not removed. A ganglion can be like a weed which will grow back if the root is not removed. In many cases, the ganglion cyst returns a er an aspiration procedure. Aspiration procedures are most frequently recommended for ganglion cyts located on
    the top of the wrist.

When Is Surgery Needed ?

Your doctor may recommend surgery if your symptoms are not relieved by nonsurgical methods, or if the ganglion returns a er aspiration. The procedure to remove a ganglion cyst is called an excision.

Surgery involves removing the cyst as well as part of the involved joint capsule or tendon sheath, which is considered the root of the ganglion. Even afer excision, there is a small chance the ganglion will return. Though the recurrence rate associated with surgery is much lower than that experienced with aspiration and injection therapy,

Excision is typically an outpatient procedure and patients are able to go home after a period of observation in the recovery area. There may be some tenderness,
discomfort, and swelling a er surgery. Normal activities usually may be resumed 2 to 6 weeks after surgery.

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