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Ganglion Cyst by Rosalyn Carson-DeWitt, MD

Definition

A ganglion cyst is a fluid-filled sac that is usually attached to either a tendon sheath or a joint lining. Ganglion cysts usually appear on the back of the wrist. They may also be on the underside of the wrist, the hand, the fingers, or the feet. Ganglion cysts are always noncancerous.

Ganglion Cyst

Causes

The cause is unknown.

Risk Factors

These factors increase your chance of developing a ganglion cyst. Tell your doctor if you have any of these risk factors:

Sex: female
Age: 20-50 years old
Participating in gymnastics

Symptoms

Symptoms include:

Appearance of a soft bump, usually on the back of the wrist
Pain or tenderness at the site of the bump

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. Most ganglion cysts are easily diagnosed based on the location and appearance. The doctor may use a small needle to remove some of the cyst's fluid for testing.

Other tests may include:

X-ray —a test that uses radiation to take a picture of structures inside the body, especially bones
MRI scan —a test that uses magnetic waves to make pictures of structures inside the affected area

Treatment

Some ganglion cysts go away without treatment. If the cyst is very tender or unsightly, you may want treatment. Even with treatment, ganglion cysts often return.

Treatments include:

Home Treatment

Ice
Ibuprofen or aspirin to relieve pain and swelling

Note: Do not attempt to smash the cyst with a heavy object (a traditional home remedy). This is unlikely to get rid of the cyst and more likely to injure you.

Immobilization

You may need to wear a splint on your wrist. Ganglion cysts usually get smaller with less activity and larger with more activity.

Aspiration

A needle is put into the cyst to drain the fluid.

Corticosteroid Injection

A steroid solution is injected into the cyst, which is usually done after the cyst is drained.

Surgery

The cyst can be surgically removed. This is done when they are large and unsightly or painful. Cysts may return even after surgery.

Prevention

There are no guidelines for preventing this condition.

RESOURCES:

American Academy of Orthopaedic Surgeons http://www.aaos.org
American Orthopaedic Society for Sports Medicine http://www.aossm.org/tabs/Index.aspx

CANADIAN RESOURCES:

Canadian Orthopaedic Association http://www.coa-aco.org/
Canadian Orthopaedic Foundation http://www.canorth.org/

References:

Canale ST, Campbell WC. Campbell's Operative Orthopaedics . 9th ed. St. Louis, MO: Mosby; 1998.
Ganglion. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated April 2008. Accessed June 23, 2008.
Goroll AH, Mulley AG. Primary Care Medicine . 4th ed. Philladelphia, PA: Lippincott, Williams, and Wilkins; 2000.
Merck Manual of Diagnosis and Therapy . 17th ed. Rahway, NJ: Merck; 1999.

Last reviewed September 2009 by Jill D. Landis, MD

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