Ganglion Cysts

Ganglion cysts are common lumps that show up in the hand and wrist near joints or tendons. They occur on the top or inside of the wrist, on the fingers where they meet the palm, or on the back of the finger near the knuckle closest to the fingernail.

The ganglion cyst sometimes looks like a bubble filled with a clear fluid or gel. What causes them to form isn't known, but it may have to do with an irritated joint or tendon. Over time, the cysts can grow, shrink, or even disappear. They aren't always painful and since they're not cancerous, they won't spread.

Ganglion cysts are usually diagnosed because of where they form and what they look like. They're usually round or oval, and can be either soft or firm. The ones on the palm where the fingers meet are usually the size of a pea and very solid, and those are sensitive to pressure, such as when you grab something. The diagnosis is facilitated by studying the cysts with light, which can often pass directly through them. X-rays are also helpful in seeing if there is any problem in the joints near the cyst, and those that show up near the ends of the fingers often come with an arthritic bone spur. 

Ganglion cysts are often treated without surgery, and if they don't cause any pain, may just be watched and left alone. When the cyst is associated with pain or discomfort, your hand doctor may recommend one of a number of treatments. For example, splints can be used to reduce some of the pain associated with these cysts or an aspiration can be performed to drain the fluid and deflate the cyst. The latter procedure, which involves sticking a needle into the cyst, can be done in the office and doesn't require hospitalization.

If the aforementioned treatments fail to ease the pain, or if the cyst reappears, there are surgical options that can be taken. During the surgery, the hand surgeon will remove the cyst and part of the joint capsule or the sheath of the tendon involved. If the ganglion cyst is on the wrist, the surgery may entail traditional or arthroscopic methods. Although the cysts may show up again later, surgery is very successful for removing them, and your hand surgeon will talk over your treatment options during your consultation.