DESCRIPTION
Ganglion cysts are very common lumps within
the hand and wrist that occur adjacent to joints or tendons. 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 (see Figure 1 below). The ganglion cyst often
resembles a water balloon on a stalk (see Figure 2 below), and is filled with
clear fluid or gel.
CAUSES
The cause of these cysts is unknown although
they may form in the presence of joint or tendon irritation or
mechanical changes. They occur in patients of all ages.
These cysts may change in size or even disappear completely, and they
may or may not be painful. These cysts are not cancerous and will not
spread to other areas.
TREATMENT
Diagnosis
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
firm. Cysts at the base of the finger on the palm side are typically
very firm, pea-sized nodules that are tender to applied pressure, such
as when gripping. Cysts at the far joint of the finger frequently have an
arthritic bone spur—which is a small bony bump or projection—associated
with them, the overlying skin may become thin, and there may be a
lengthwise groove in the fingernail just beyond the cyst.
Ultrasound or other advanced imaging such as magnetic resonance
imaging (MRI) may be helpful in confirming the diagnosis. There are
different types of growths that can occur around the and wrist, and
additional imaging is sometimes required.
Treatment
Treatment can often be non-surgical. In many cases, these cysts can
simply be observed, especially
if they are painless, as they frequently
disappear spontaneously. If the cyst becomes painful, limits activity,
or is otherwise unacceptable, several treatment options are available.
The use of splints and anti-inflammatory medication can be prescribed in order to decrease pain associated with activities.
An aspiration can be performed to remove the fluid from the cyst and
decompress it. This requires placing a needle into the cyst, which can
be performed in most office settings. Aspiration is a very simple
procedure, but recurrence of the cyst is common. If non-surgical options
fail to provide relief or if the cyst recurs, surgical alternatives are
available.