WHAT ARE GANGLION CYSTS?
Lumps and bumps on the hand, wrist, or forearm can be a cause of significant anxiety for patients but are rarely anything too serious. Benign cysts and masses are actually very common in the hand and wrist, and often don’t cause significant problems. They can however sometimes cause pain or limit function. Malignant or cancerous tumors of the hand, wrist, or forearm are exceedingly uncommon, but we recommend you have any new lump or bump checked out.
Ganglion cysts are very common benign fluid-filled cysts that usually occur near joints or tendons. The most often occur on the back of the wrist. Old wive's tales suggested to strike the cyst with a Bible to rupture it...but I certainly don't recommend that! There are much better, and less painful ways to treat ganglion cysts.
CAUSES?
The cause of most ganglion cysts is unknown. Occasionally there is a history of injury to the area. Mucous cysts that occur near the fingernails are usually associated with osteoarthritis of the adjacent joint. Wrist ganglion on the other hand often occur in young patients without history of wrist injury.
SYMPTOMS?
Ganglion cysts often begin as painless lumps under the skin but may start to ache or inhibit joint motion as they grow over time. Wrist ganglion may fluctuate in size. Mucous cysts which occur around the fingernails sometimes become thin and blister-like and can rupture with minor trauma. Seed ganglion in the palm often feel hard and are quite tender to touch.
Common Ganglion Cyst Locations:
Fingers:
- Around the joint at the base of the fingernail (mucous cysts)
Palm:
- Around the pad of the palm / base of fingers (seed ganglion)
Wrist:
- Palm / thumb side of wrist (volar wrist ganglion)
- Back / center of wrist (dorsal wrist ganglion)
IS THERE A TEST FOR GANGLION CYSTS?
Your symptoms and medical history as well as an examination of your hand and wrist can help to diagnose the mass or cyst. Occasionally I recommend an MRI or biopsy for confirmation of the diagnosis if it has unusual features.
When should you be more concerned about lumps and bumps?
All new or changing lumps and bumps should be checked out. Even benign ones can be painful or limit function and may benefit from simple treatments. Severe pain, rapid growth, and skin ulcerations definitely warrant more urgent medical attention.
TREATMENT
Treatment options depend on the type and location of the cyst or mass, and whether it is symptomatic.
Nonoperative:
Simple cysts or masses can often just be observed if they are not painful, limiting function, or growing. Some fluid-filled cysts like wrist ganglion cysts can often be drained in the office.
Operative:
Painful cysts or masses, those that are limiting function, or those that show concerning features like rapid growth can often be surgically removed. The biopsy tissue can be sent to the lab for identification if the diagnosis is questionable.
READY TO CONFIRM A DIAGNOSIS AND FIX THE PROBLEM OR JUST WANT TO LEARN MORE?
I am here to help! I can often diagnose the problem in one visit, and get you started with a treatment plan. I offer a wide variety of both nonoperative and operative treatment options.
Call Hand Institute of Charleston today for a clinic or telehealth appointment! 854-423-4263
This article is not a substitute for expert medical advice or diagnosis and is for educational purposes only.
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