Demystifying Ganglion Cyst: Diagnosis and Treatment
A ganglion cyst is a very common firm swelling like a lump at the hand and wrist that appears near the bones and tendons. The most frequent location is around the wrist. They are frequently found in common locations and are often seen on the back of the wrist in the middle. They can also be at the palmar surface of the wrist or around a finger joint. When they are on the palm of the wrist, they are typically close to the thumb. The ganglion cyst is usually filled with a clear, gel-like fluid.
Imagine the ganglion like a balloon in a straw. The straw is like a tube connecting to a joint or tendon. Normally all joints and tendons are surrounded by fluid. This fluid travels through the tube and makes the cyst size increase or decrease. Some cysts may disappear completely over time. A ganglion cyst is not related to cancer and does not spread to other areas.
A ganglion cyst can occur in kids and in adults. In the majority of the cases we cannot identify a specific cause. Sometimes they occur after repetitive sports; especially racket sports like paddle tennis, badminton and heavy load on the wrist while exercising at the gym. Seldom the cause is arthritis or gout.
Most of the time ganglion cysts are not painful. The cysts are usually round, soft and easily compressed. They can cause pain if there is an associated ligament injury or pressure around a tendon or a nerve.
Diagnosis is a combination of clinical examination and radiological studies ( x-ray, ultrasound). Your Orthopedic Hand Surgeon will perform a thorough examination over the wrist to see where the pain is localized and how the wrist and cyst moves. More advanced radiologic studies might be necessary (MRI), especially to differentiate from other conditions.
Treatment for a ganglion cyst most of the time is non-surgical. Ganglions can simply be observed, especially if they are painless. Ganglion cysts could disappear spontaneously. If the ganglion increases in size and becomes painful, limiting activity; several treatment options are available.
The treatment of ganglion depends on the severity of symptoms. It can include various combinations of activity modification, splinting or casting, hand physiotherapy, anti- inflammatory medicine, removal of the fluid or injections. If non-operative treatment does not relieve symptoms,or if the cyst reoccurs,surgery might be the next step for treatment.
