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What is a Mucous Cyst?

A mucous cyst is a synovial cyst appearing either on top of the knuckle near the fingernail or adjacent to the cuticle. This condition is usually caused by a near-lying arthritic joint and occurring most often in the middle or index finger of the dominant hand. They are benign and may vary in size over time.

In patients with persistent and painful cysts that stretch the overlying skin excessively or cause nail deformities, there may be a need for surgical removal and joint debridement.

Characteristics and Clinical Presentation of a Mucous Cyst

The typical mucous cyst is small. As a fluid-filled sac forming on the fingers, it generally develops in patients 50-70 years of age. They typically appear at the joint nearest to the fingernail, called the distal interphalangeal joint (DIPJ). They can be found on the thumb or any of the other fingers on the hand. They generally begin as small and sometimes painful nodules in the DIPJ joint area. Many patients who develop mucous cysts also present with osteoarthritis of the involved joint.

Most mucous cysts tend to be painless, but some can be tender to the touch. They can also deform the nail bed. If the skin on the cyst breaks, it will drain with clear, viscous fluid.

Getting a Diagnosis for Mucous Cysts

Your hand surgeon will begin by asking for a history of your problem with your fingers and joints, followed by a thorough examination of the finger. An X-ray of the affected finger may be necessary to visualize any degeneration related to osteoarthritis in the distal interphalangeal joints.

Treatment Options for Mucous Cysts

There are nonsurgical and surgical treatment plans for mucous cysts. Nonsurgical management involves close observation of the cyst with regular check-ups. In the event of a rupture, a direct line from the skin into the joint is opened, which can lead to serious infection. A cyst should never be punctured at home for any reason.

Conservative Treatments

For many patients, nonsurgical management is enough. In these cases, your hand surgeon will want to observe your cyst through a series of check-ups to keep track of the overlying skin for potential tearing. It is important to see an experienced hand surgeon like Drs. Pruzansky because of the careful management mucous cysts require.

Surgical Treatments

If surgical intervention is required, many mucous cysts can be treated with outpatient surgical reconstruction with an excision procedure. This procedure involves trimming and smoothing of osteophytes that will allow the capsule to heal surrounding the joint. If the skin surrounding the cyst is damaged, an excision may be required to remove this skin from the finger. Surgery of this nature is typically performed with regional anesthesia, as an outpatient procedure.

Preventing Mucous Cysts

Because the cause of mucous cysts is usually osteoarthritis, preventative methods are not clear. Early evaluation and treatment by an experienced hand surgeon are recommended, alongside long-term evaluation of the cyst site. Following the diagnosis of your mucous cyst, it is recommended to keep in close contact with your surgeon to monitor its progress.

Prognosis for Mucous Cysts

Mucous cysts are not cancerous. Surgical options are generally the recommended treatment option, however, nonsurgical management is beneficial in some cases, Surgical requires little to no downtime. The immobilization period is brief and many patients can look forward to the same function in the affected region that they had before surgery.

If You Believe You Have a Mucous Cyst, Contact HandSport Surgery Institute.

Please contact us as soon as possible to schedule an appointment with our talented team. People who notice cysts developing on their hands should be evaluated to try and prevent injury or 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.

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