Ganglions (Cysts) of the Wrist

Definition: Ganglion cysts are noncancerous lumps that most commonly develop along the tendons or joints of the wrists or hands. These cysts are filled with a jelly-like fluid and can vary in size. They are typically round or oval and are among the most common benign soft-tissue masses.

Causes:

• Joint or Tendon Irritation: Often associated with repetitive stress or irritation of the joint or tendon sheath.
• Injury: Previous trauma or injury to the wrist can contribute to cyst formation.
• Age and Gender: Ganglion cysts are more common in younger individuals, particularly women aged 20-40.
• Unknown: In many cases, the exact cause of ganglion cysts is not known.

Symptoms:

• Visible lump or swelling on the wrist, often on the back of the hand but can also occur on the palm side
• Pain or discomfort, particularly when using the wrist or hand
• Changes in size, with cysts sometimes becoming larger with increased activity and shrinking with rest
• Numbness or tingling if the cyst presses on a nerve

Diagnosis:

• Physical Examination: Assessing the cyst’s size, location, and tenderness.
• Imaging Tests: Ultrasound or MRI may be used to confirm the diagnosis and to rule out other conditions.
• Aspiration: Extracting fluid from the cyst with a needle to analyze it and confirm the diagnosis.

Treatment:

1. Non-Surgical Treatments:

   • Observation: Many ganglion cysts are painless and may disappear on their own without treatment.
   • Immobilization: Wearing a wrist brace or splint to reduce movement and encourage the cyst to shrink.
   • Aspiration: Draining the fluid from the cyst with a needle, though cysts may recur.

2. Surgical Treatments:

   • Cyst Excision: Surgical removal of the ganglion cyst, often recommended if the cyst is painful, recurrent, or limits wrist function. This procedure can be done using traditional open surgery or arthroscopy.

Prognosis: Ganglion cysts are generally harmless and noncancerous. Many people experience relief from symptoms with non-surgical treatments. However, recurrence is common, especially if only aspiration is performed. Surgical removal has a lower recurrence rate, but it also carries the risks associated with any surgical procedure. Regular monitoring and follow-up care can help manage any recurring cysts and ensure optimal wrist function.