Ganglion Cysts
Ganglion Cysts
Ganglion Cysts
They can be found at different places on the wrist. A ganglion cyst that
grows on the top of the wrist is called a dorsal ganglion. Others are found on
the underside of the wrist between the thumb and your pulse point, at the
end joint of a finger, or at the base of a finger. Most of the time, these are
harmless and will often disappear in time.
Cause
A ganglion cyst contains a thick, clear, mucus-like fluid similar to the fluid
found in the joint. No one knows what triggers the formation of a ganglion.
Women are more likely to be affected than men. Ganglia are common
among gymnasts, who repeatedly apply stress to the wrist.
Symptoms
Because the fluid-filled sac puts pressure on the nerves that pass through
the joint, some ganglion cysts may be painful. Large ganglia, even if they
are not painful, are unattractive. Smaller ganglions that remain hidden
under the skin (occult ganglions) may be quite painful.
A ganglion grows out of a joint, like a balloon on a stalk. It rises out of the
connective tissues between bones and muscles. Inside the balloon is a thick,
slippery fluid similar to the fluid in your joints. Usually, the more active the
wrist, the larger the cyst becomes. With rest, the lump generally decreases
in size.
Diagnosis
Your doctor 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. 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
Initial treatment is not surgical.
• Observation. Because the ganglion is not cancerous and may
disappear in time, just waiting and watching may be enough to
make sure that no unusual changes occur.
• Immobilization. Activity often causes the ganglion to increase in
size. This is because activity increases pressure on nerves, causing
pain. A wrist brace or splint may relieve symptoms, letting the
ganglion decrease in size. As pain decreases, your doctor may
prescribe exercises to strengthen the wrist and improve range of
motion.
• Aspiration. If the ganglion causes a great deal of pain or severely
limits activities, the fluid may be drained from it. This procedure is
called "aspiration." The area around the ganglion cyst is numbed
and the cyst is punctured with a needle so that the fluid drains
away.
Nonsurgical treatment leaves the outer shell and the stalk of the ganglion
intact, so it may reform and reappear.
The ganglion cyst can be removed through outpatient surgery, but this is no
guarantee that the cyst will not grow again. Surgery may also include
removing part of the involved joint capsule or tendon sheath. There may be
some tenderness, discomfort, and swelling after surgery. Normal activities
usually may be resumed two to six weeks after surgery.