Ganglion cysts

Ganglion cysts (also called ganglia) are benign, fluid-filled swellings that arise from joints or tendon sheaths. They contain synovial fluid and are the most common type of lump found in the hand and wrist.

Symptoms

• A visible and palpable lump on the dorsal or palmar surface of the wrist, or on the fingers
• The size may fluctuate with activity
• Pain or discomfort during certain wrist movements
• Occasional compression of nearby nerves, causing tingling
• Cosmetic concern due to the visible deformity

Causes

Ganglion cysts form as a result of weakness or irritation of the joint capsule or tendon sheath, which allows synovial fluid to escape. They are more common in young women and may appear after trauma or repetitive strain, although in many cases no clear cause is identified.

Diagnosis

Clinical examination is usually sufficient. The cyst is typically soft, mobile and transilluminates when a light is held against it. In cases of uncertainty, ultrasound confirms the diagnosis and helps assess its relationship with surrounding structures.

Treatment

Many ganglion cysts resolve spontaneously without the need for treatment. If they cause pain or concern, aspiration (needle drainage) with or without corticosteroid injection may be performed. When the cyst recurs or persists, surgical excision is the definitive treatment, with a low recurrence rate.

Recovery

Following surgery, a dressing is worn for a few days and normal activities can be resumed within two to three weeks. It is advisable to avoid heavy wrist loading during the first month.