What is a Ganglion Cyst?
A ganglion cyst is a mass of benign tissue. Ganglion cysts are non-cancerous fluid or gelatin-filled bumps that most often appear on a damaged ligament or tendon of the wrist, although they can appear almost anywhere on the fingers, hands, and wrists.
They may occur in people who use their wrists in strenuous physical activities like gymnastics, tennis, golf or guitar- or bass-playing, although usually no association to anything is made. They may be congenital—appearing in infants or run in family members.
Characteristics and Clinical Presentation of a Ganglion Cyst
Some ganglion cysts will go away or vary in size over time, causing nothing more than a lump. Troubling and painful cases may be treated with splinting, aspiration, NSAIDs, cortisone injections, and arthroscopic or mini-open surgery. Sometimes, ganglion cysts are a sign of a more significant, underlying ligament or tendon injury, which requires additional medical attention.
The exact cause of this condition is unknown, though it is believed that risk factors include women between the ages of 20 and 40, patients with a history of osteoarthritis, or previous joint and tendon injury.
Lumps associated with ganglion cysts are characterized by:
- Pain: Ganglion Cysts are often painless unless they press on a nerve, even if the bump is unnoticeable.
- Shape: Ganglion Cysts are typically oval in shape.
- Size: They may be pea-sized or measure up to an inch in diameter.
Getting a Diagnosis for Ganglion Cysts
A physical examination is the first test for a patient presenting with symptoms associated with a ganglion cyst. Pressure may be applied to the dorsiflexed wrist or directly on the cyst to test for tenderness or discomfort. A light shone through the cyst may determine if it’s filled with fluid or a solid mass.
Imaging tests such as X-rays, ultrasounds, magnetic resonance imaging (MRI), or CT scans will be used to rule out conditions with overlapping symptoms or conditions. These may include arthritis, ligament and bone injuries, or other types of tumors.
Treatment Options for Ganglion Cysts
A ganglion cyst often requires no treatment. Because they are typically painless, your surgeon may suggest a period of observation. However, if the cyst begins to cause discomfort or begins to impinge upon joint movement, intervention may be required.
Patients who present with symptoms associated with a ganglion cyst should seek medical supervision to begin the diagnostic process and begin treatment.
Most painful cysts can be treated with brief immobilization. Activity may cause the cyst to grow in size, thus necessitating immobilization with a splint or brace. If the cyst shrinks, pain and pressure on the nerves may be released.
If this does not prove to provide a long-term solution, your surgeon may recommend aspiration, in which a surgeon uses a needle to drain fluid from the cyst. The cyst has a likelihood of recurrence.
Surgical intervention is recommended if conservative methods have not worked—pain persists, motion diminishes, ADL are impacted. During a surgical procedure, the cyst and the stalk attached to the joint or tendon are removed and damaged supportive tissues repaired to minimize recurrence.
Preventing Ganglion Cysts
The cause of ganglion cysts is not known. As a result, a clear-cut approach to prevention is unknown. Early evaluation and treatment are recommended, as well as long-term evaluation of sites of origin and cysts removed surgically or aspirated where symptoms recur. Loss of motion may be silent. Following the diagnosis of ganglion cysts, keep in close contact with your hand surgeon to monitor its progress.
Prognosis for Ganglion Cysts
Ganglion cysts are not cancerous. Some cysts resolve without treatment particularly children and young adults within a few months to years—less commonly after 20. Surgical treatments are the primary option of treatment, followed closely by aspiration. Patients with no symptoms that interfere with daily life do not often require treatment.
Surgery requires little downtime. Immobilization is brief and five digits are free for light use. Rehab is sometimes helpful after the first post-op evaluation.
If You Believe You Have a Ganglion Cyst, Contact HandSport Surgery Institute.
Please contact us as soon as possible to schedule an appointment with our talented team. People who have been pain or stiffness should be evaluated to try to reduce further damage and mobility issues.
If you have been injured, it’s important to be evaluated by a highly skilled professional. Call Drs. Mark and Jason Pruzansky at 212-249-8700 to schedule an appointment and obtain an accurate diagnosis.