Ganglion Cyst

By: Nichole Joslyn, MD

What is a ganglion cyst?

A ganglion cyst is a benign (or noncancerous) lump that typically develops along the tendons or joints in the wrist or hand. Most commonly they develop on the back of the wrist or near the finger joint closest to the fingernail (in this location we refer to it as a mucous cyst). They can also occur in the ankles or feet.

The cyst is filled with a jelly like material. In fact, if you turn off the room lights and shine a penlight through the mass, it will transilluminate because of this.

It is important to note that these are noncancerous. The lumps can resolve on their own. However, if the cyst is causing symptoms such as pain or numbness, then there are treatment options available.

Who gets ganglion cysts?

Ganglion cysts can occur in anyone, but they most commonly occur in women between the ages of 20 and 40, in patients with arthritis, or with a previous joint or tendon injury.

What can you expect at your doctor’s visit?

Your doctor will ask you questions such as: how long the cyst has been there, if it has changed, if you have any previous trauma, if you have any pain or difficulties with using your hand or wrist. Your doctor will also perform a physical exam to evaluate the mass and your overall hand and wrist function. They will likely obtain x-rays to evaluate for any underlying trauma or arthritis. Ultrasounds and MRIs may be needed depending on what is found during your discussion and exam.

Non-operative treatment:

1. Splinting: Temporarily wearing a splint or a brace may help alleviate some discomfort by immobilizing the area. It is important to avoid long term use, which can cause weakening of the nearby muscles.
2. Aspiration: Your doctor may discuss using a needle to drain the fluid from the cyst. They may or may not inject steroid into the cyst after the fluid is drained. Cysts that are aspirated tend to frequently come back.

Operative treatment:

Surgery is typically reserved for patients who have symptoms related to the cyst. Your surgeon will remove the cyst and the stalk that connects to the joint or tendon. If there is underlying arthritis, this may need to be addressed as well. It is important to note that the cyst can recur, even after surgery.

The decision between operative and non-operative treatment is entirely up to the patient and the surgeon. Please feel free to ask questions.