Department of hand surgery & Microsurgery.

Ganglions of Hand

What is a ganglion cyst ?

Ganglion cysts are soft, gel-like masses that often change size. They tend to be smooth and round, and are:

  • the most common type of swelling in the hand, wrist and foot
  • harmless and can safely be left alone
What causes ganglion cysts?

A ganglion cyst starts when the fluid leaks out of a joint or tendon tunnel and forms a swelling beneath the skin. The cause of the leak is generally unknown, but may be due to trauma or underlying arthritis.

How common are they?

Ganglion cysts are 3 times more common in women than men between 20 and 40 years of age.

Types of ganglion cysts

Ganglions can form:

  • At the back of the wrist ( Dorsal wrist ganglion )- these typically occur in young adults and often disappears without treatment
  • At the front of the wrist ( Volar wrist ganglion ) - these may occur in young adults, but also seen in older people with arthritis
  • At the base of the finger (flexor tendon sheath) - these usually occur in young adults Eg : A1 pulley ganglion.
  • On the finger (mucoid cyst) - these usually occur in middle-aged or older people

Approximately 80% of ganglions are found in the wrist.

Ganglion cyst symptoms

If you have a ganglion cyst the swelling can become noticeable, but often there are no symptoms at all. Sometimes a ganglion can cause pain and limit movement in your joint. Some people are also concerned about the cysts appearance. Most symptoms settle with time.

How they're diagnosed

To diagnose a ganglion cyst, your doctor will ask you about it and examine your wrist and hand. Giving a diagnosis is usually straightforward. However, scans may be helpful if the diagnosis is uncertain. Most often an Ultra Sound Scan suffice. MRI is done only in complicated cases.

Treating a ganglion cyst

About 50% of ganglions disappear on their own without treatment. In the early stages you should wait to see if this happens. You won't need treatment unless the cyst is painful.

Medication

Many people take medication to cope with their pain and symptoms, and help them remain active. You may be prescribed pain medication to ease the pain. Make sure you take any medication as prescribed.

Surgery

If the ganglion hasn't reduced in size after 6 months or is causing significant functional difficulty and/or pain, you may be referred for further help and possible surgery. Surgery is considered if it causes significant pain or restricts movement in your joint. However, there's a 10%- 30% chance it will come back even after surgery.