Ganglion Cyst of the Wrist
Arizona Orthopedic Surgery Solutions for Ganglion Cyst of the Wrist
What is Ganglion Cyst of the Wrist
Ganglion cysts are the most common mass or lump in the hand. They are not cancerous and, in most cases, are harmless. They occur in various locations, but most frequently develop on the back of the wrist. These fluid-filled cysts can quickly appear, disappear, and change size. Many ganglion cysts do not require treatment. However, if the cyst is painful, interferes with function, or has an unacceptable appearance, there are several treatment options available. A ganglion rises out of a joint, like a balloon on a stalk. It grows out of the tissues surrounding a joint, such as ligaments, tendon sheaths, and joint linings. Inside the balloon is a thick, slippery fluid, similar to the fluid that lubricates your joints. Ganglion cysts can develop in several of the joints in the hand and wrist, including both the top and underside of the wrist, as well as the end joint of a finger, and at the base of a finger. They vary in size, and in many cases, grow larger with increased wrist activity. With rest, the lump typically becomes smaller.
The doctor will address the individual’s medical history and symptoms. Most importantly, the doctor will ask how long the cyst has been present, if it causes any pain, and if the size has changed at all. The doctor will push on the cyst to see if there is any pain, and if so, where specifically. A light may be used to see if the cyst is translucent, as the fluid in the cyst should allow some light through in order to diagnose it as a ganglion cyst. X-rays can be used to make sure the ganglion cyst isn’t arthritis or a tumor on the bone. A magnetic resonance imaging (MRI) scan or an ultrasound will reveal soft tissue, unlike an x-ray. The two tests will be able to reveal ganglion that is otherwise not visible and like the x-ray, can help confirm the cyst isn’t a tumor.
Ganglion Cyst Cause
It is not known what triggers the formation of a ganglion. 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. These 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.
Ganglion Cyst Symptoms
Most ganglions form a visible lump, however, smaller ganglions can remain hidden under the skin (occult ganglions). Although many ganglions produce no other symptoms, if a cyst puts pressure on the nerves that pass through the joint, it can cause pain, tingling, and muscle weakness.
Large cysts, even if they are not painful, can cause concerns about appearance.
Medical History and Physical Examination
During the initial appointment, your doctor will discuss your medical history and symptoms. He or she may ask you how long you have had the ganglion, whether it changes in size, and whether it is painful.
Pressure may be applied to identify any tenderness. Because a ganglion is filled with fluid, it is translucent. Your doctor may shine a penlight up to the cyst to see whether light shines through.
X-rays. These tests create clear pictures of dense structures, like bone. Although x-rays will not show a ganglion cyst, they can be used to rule out other conditions, such as arthritis or a bone tumor.
Magnetic resonance imaging (MRI) scans or ultrasounds. These imaging tests can better show soft tissues like a ganglion. Sometimes, an MRI or ultrasound is needed to find an occult ganglion that is not visible or to distinguish the cyst from other tumors.
Ganglion Cyst Treatment
As ganglion is noncancerous and usually disappears with time, you may be able to keep an eye on it and make sure nothing out of the ordinary happens. The use of a brace or splint will keep pressure on the cyst, hopefully helping mobility and decreasing the size of the cyst as well as pain. For severe ganglion cysts atop the wrist, a doctor may recommend draining the cyst, a process known as aspiration. The surrounding area is numbed so the cyst can be painlessly punctured with a needle to drain the fluid. As the connection of the cyst (known as the “root”) to the joint or tendon is not removed, it is likely the cyst will grow back. A surgical procedure, known as excision, can be done to remove the cyst and the “root” in the joint capsule or tendon sheath, however, there is a small likelihood of the cyst growing back. Following an excision, patients spend a few minutes in observation in a recovery room before they are allowed to leave. It is normal for sensitivity, swelling, and minor pain to be present following an excision. Fortunately, excision recovery only takes about two to six weeks before regular activity can resume.