Ganglion cysts are the most common type of lumps found on the hand and wrist. They usually appear on the back of the wrist, the palm side of the wrist, or at the top of the end joint of the finger. The cyst is filled with a clear gelatin-like fluid. It may change in size, and it is noncancerous.
These are globular sac-like lumps or cysts that are formed from internal degeneration of a tendon or are a protruded extension of a joint capsule, filled with synovial fluid. They are often found on the long extensor tendons. Ganglion cysts have the following characteristics :
1. Ganglion cysts are non-cancerous.
2. The fluid within the cysts is similar to that contained within synovial joints.
3. Draining or surgically removing the cysts treats and may prevent recurrence.
4. They most commonly occur next to the wrist joints, but they can affect the feet.
Risk Factors for Ganglion Cysts
Majority of patients with ganglion cysts are adults between 15 and 40 years old, but anyone can get one. There is no known cause for ganglion cysts, but there are several factors that have been linked to their occurrence:
- Injury to the wrist or finger joint
- Inflammation or irritation in the tendons or joints
- Repetitive activities that use the wrists and fingers
- Chronic illness, such osteoarthritis
Symptoms of Ganglion Cysts
Common signs and symptoms of ganglion cysts include:
- Round mass on wrist or finger joint, which may be firm or soft to the touch
- Thinned skin or a grove along the fingernail may occur with cysts at the end joint of the finger
The diagnosis is usually based on the location of the lump and its appearance. They are usually oval or round and may be soft or very 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.
Treatment of Ganglion Cyst
Initial treatment of ganglion cysts is often non-surgical. If the cyst becomes painful or limits activity, there are various treatment options:
- Splint to immobilize the wrist or foot
- Anti-inflammatory medications
If the cyst becomes painful, limits activity, or is otherwise unacceptable as to the look and feel of it, several treatment options are available.
An aspiration can be performed under local anaesthesia to remove the fluid from the cyst and decompress it followed by steroid injection in the ganglion cyst cavity. Most of the time, this may suffice but if the cyst recurs, surgical option may be indictaed. Surgery involves removing the cyst along with a portion of the joint capsule or tendon sheath.
Aspiration and steroid injection treatment :
The fluid inside a cyst is similar to that which naturally occurs in joints. Removing the fluid may permanently remove the cyst and the simultaneous steroid injection is aimed at treating the inflammation and promoting ganglion cyst wall adhesion, so that there is little to no cyst cavity left behind.
Open surgery :
A small incision is made over the ganglion cyst and the cyst is carefully dissected and removed , together with the stalk.
45 – 60min
May last a long time