Ganglion cyst (wrist)

Lumps and swellings around the wrist

A ganglion cyst is one of the most common soft tissue masses affecting the hand and wrist and can affect people of any age. Not all swellings are ganglia, if in doubt let us check it out for you.

What are ganglion cysts?

Ganglion cysts are usually small swellings commonly about 1-2 cm in size and affect the dorsal side (top of the joint) of the hand more than the palmar side.

Symptoms of a ganglion cyst

While the nature of a ganglion cyst is completely benign (they are not cancerous), those affected often mention the aesthetic appearance. Patients may find that the cyst comes and goes and its size varies, so that it is sometimes painful and can interfere with normal hand function. For some people the impact of having a ganglion cyst can be very irritating but to others it can be of little or no concern.

Causes: How does a ganglion cyst occur?

The exact cause is not totally understood but it is thought to be the result of repetitive microtrauma to the affected area, which in turn causes the lining of the joint (the synovium) to fill with excess fluid (synovial fluid rich of hyaluronic acid) produced by specialised cells which are present in that area (fibroblasts). The fluid-filled sac which forms is the result of this process and its content is clear and thick, which gives the cyst its peculiar feature of transillumination (light can pass through it).

Diagnosis: How we spot a ganglion cyst

The diagnosis is usually quite straightforward and if there is any doubt an ultrasound or MRI scan can help.

Ganglion cyst surgery

There are usually three general treatment approaches: observation, aspiration and surgical removal. Some patients visit their consultant in order to simply confirm their condition and do not wish to proceed with any further treatment. However, for those who wish to eliminate the cyst, it can either be aspirated or removed through minor surgery.

Ganglion cyst (wrist) surgery

Aspiration can be performed in a treatment room and involves sterilising the area, injecting local anaesthetic for pain control and aspirating the fluid inside the cyst with a small needle and a syringe under ultrasound guidance. Some anti-inflammatory medication (cortisone) can be injected afterwards to alleviate pain and often a period of rest with use of a splint can follow this treatment.

Alternatively, the cyst can be removed via a small incision or arthroscopically (keyhole surgery) as a day-case surgery. While this procedure is slightly more invasive, it seems to lead to lower recurrence rates when compared to aspiration (21% versus 59%). Therefore, treatment option is a shared one to be discussed between you and your consultant.

Ganglion cyst: Our wrist specialists

Ganglion cyst: Our specialised hospital