Ganglion Cyst Of The Hand
Ever noticed a bump on the back of someone's wrist or had one yourself. It may be a ganglion cyst. These are benign cyst which are very common. The most common location for one is the top (dorsum) of the wrist (60-70%). They may also occur on the bottom-side (volar) of the wrist, at the end joint of a finger (distal phalangeal joint), or at the base of a finger (palm-side).
There is no known specific cause for ganglions, but often there has been an injury before the appearance of the cyst. A ganglion cyst contains a thick, clear, mucus-like fluid similar to the fluid found in the joint. These cysts can be painful, especially when they first appear and with constant or strenuous use of the hand or wrist. Ganglions often change in size and may disappear completely.
The diagnosis of a ganglion cyst is based on where the cyst is and what it looks like. Your doctor may ask you how long you've had the ganglion, whether it changes in size, and whether it is painful. Pressure may be applied to identify any tenderness. A penlight may be held up to the cyst to see whether light shines through. X-rays may be taken to rule out other conditions, such as arthritis or a bone tumor. Sometimes, an MRI or ultrasound is needed to find a ganglion cyst that is not visible.
Treatment of ganglion cysts may consist of
Doing nothing. The cysts are benign and if yours is not painful, does not limit activity, and its appearance is acceptable to you, then there is no reason for further treatment. Just watch it for changes.
If it is painful, does limit activity, or you dislike its appearance, then treatment may include removing fluid from the cyst (putting a needle into the cyst and aspirating) and /or wearing a splint to keep the hand or wrist from moving.
If these non-surgical treatments fail, surgery to remove the cyst can be done. This surgery is performed on an outpatient basis. Anesthesia may be local, regional (where only the arm is numbed), or general. 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 for a few weeks. Some patients may feel tenderness, discomfort, and swelling at the site, but full activity can be resumed once comfort permits. While surgery offers the best success in removing ganglions, these cyst can and do return.