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Ganglion Cyst on Your Wrist: Treatment and Removal

Ganglion cyst on wrist treatment
Treatment for a ganglion cyst on your wrist can include immobilization, aspiration and potentially surgery.

Ganglion cysts are the most common cysts, masses or lumps in the wrist or hand. They are not cancerous and, in most cases, are harmless. These fluid-filled cysts can quickly appear and grow bigger, occurring in various locations but most frequently developing on the back of the wrist in 60 to 70 percent of cases.

Many ganglion cysts do not require treatment. However, if the cyst is painful, interferes with function or has an unacceptable appearance, there are several conservative treatment options and surgeries available.

What is the pathogenesis of ganglion cyst?

The most common location of a ganglion cyst is on the back of the wrist, which rises out of a joint like a balloon. It grows out of the tissues surrounding the joint, such as ligaments, tendon sheaths and joint linings. Inside the balloon is a thick, slippery fluid, which is similar to the fluid that lubricates the joints.

Ganglion cysts can develop in several joints in the hand and wrist, including both the top and underside of the wrist and the end joint, as well as the base of a finger. They vary in size, but in most cases, grow larger with increased wrist activity. With rest, the lump typically becomes smaller.

What causes a ganglion cyst?

It is not known what triggers the formation of a ganglion cyst. They are most common in people aged between 15 and 40 years old, and women are more likely to be affected than men. These cysts are also common among gymnasts, who repeatedly stress their wrists.

What are the signs and symptoms of a ganglion cyst?

The signs and symptoms of ganglion cysts are:

  • Most ganglions form a visible lump, but smaller ones can remain hidden under the skin (occult ganglions). Many ganglions produce no other symptoms. However, if a cyst puts pressure on the nerves that pass through the joint, it can cause pain, tingling and muscle weakness.
  • Large cysts, even if they are not painful, can cause concerns due to their appearance.

How is ganglion cyst diagnosed?

Ganglion cysts can be diagnosed using the following ways:

  • One test to diagnose a ganglion cyst is to hold a light source, such as a small flashlight, against the cyst. A normal ganglion cyst will transilluminate, meaning light will pass through it, indicating it is not a solid mass.
  • X-ray is also recommended just to ensure the anatomy and structure of the hand and wrist are normal.
  • Magnetic resonance imaging (MRI) can better show soft tissues, such as a ganglion.

How is ganglion cyst treated?

Treatment options include:

  • Immobilization:
    • Activity often causes the ganglion to increase in size, which increases pressure on nerves and causes pain.
    • A wrist brace or splint may relieve symptoms and cause the ganglion to decrease in size.
    • As pain decreases, exercises to strengthen the wrist and improve range of motion are suggested.
  • Aspiration:
    • Aspiration procedures are most frequently recommended for ganglions located on the top of the wrist.
    • If the ganglion causes a great deal of pain or severely limits activities, the fluid may be drained from it.
    • The area around the ganglion cyst is numbed and the cyst is punctured with a needle so that the fluid can be withdrawn.
  • Surgery:
    • Surgery involves removing the cyst as well as part of the involved joint capsule or tendon sheath, which is considered the root of the ganglion.

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