Cyst Removal

Ganglion Cyst

What is a ganglion cyst?
A ganglion cyst is the most common soft tissue mass of the hand and wrist. It's a non-cancerous fluid-filled sac that usually results from a joint or tendon sheath. It can start off small and later enlarge, developing singly or have many lobes. Ganglion cysts most commonly develop on the back of the wrist and can also be found on the front of the wrist, in the palm at the base of the finger or just behind the fingernail.

How is it caused?
The exact cause is not known, but it may be related to trauma or degeneration of the adjacent tissue lining a joint or tendon sheath. Cysts at the base of the fingernail are related to degenerative arthritis of the tip joint of the finger.

What are the symptoms?
They're usually painless but may cause localized discomfort. Cysts in the palm at the base of the finger may cause discomfort with grasping activities, and ones at the base of the fingernail may cause a nail deformity. The cysts may remain stable, increase in size or go away over time.

How does the doctor know that I have a ganglion cyst?
It can typically be diagnosed after examination and description of the symptoms. The cyst is adherent to the joint capsule or tendon sheath, and light can be shown through extremely large cysts. An ultra sound or MRI can be used to help confirm the diagnosis.

How is it treated?
Splints and pain medication can help limit symptoms. An aspiration, which involves pulling the fluid out of the cyst with a needle, can be diagnostic and therapeutic. About half of all cysts do not reappear after aspiration. The diagnosis is confirmed if the typical gelatinous material is obtained.

Is surgery needed?
If the cyst is painful or too big, you can surgically remove it. The procedure is performed as an outpatient under local anesthesia and involves removing the cyst sac with the content.

What are the risks of surgery?
The cyst comes back in about 10 percent of cases. Joint stiffness may also occur. The cyst on the palm side of the wrist is adjacent to the radial artery that is at risk. Infections after surgery are rare.