Ganglion cyst of the wrist and hand (Ganglion Cyst of the Wrist and Hand) -OrthoInfo - AAOS

Ganglion cyst of the wrist and hand (Ganglion Cyst of the Wrist and Hand) -OrthoInfo - AAOS

Ganglion cyst of the wrist and hand (Ganglion Cyst of the Wrist and Hand) -OrthoInfo - AAOS

Copyright 2014 American Academy of Orthopedic Surgeons

Ganglion cyst of the wrist and hand

Ganglion cysts (or tumors cystic) are the most common nodule formation in the hand. They are not cancerous and, in most cases, do no harm. They occur in several locations, but most often develop on the back of the wrist.

These cysts filled with fluid can quickly appear, disappear and resize. Many ganglion cysts do not require treatment. But if the cyst is painful, interferes with function or looks unacceptable, there are several treatment options available.

The most common location of the lymph node is the dorsum of the wrist.

A ganglion cyst arises in a joint, like a balloon on a peduncle. It grows from the tissues surrounding a joint, such as ligaments, tendon sheaths and joint coatings. Inside the balloon, there is a thick, viscous liquid, similar to the fluid that lubricates the joints. Ganglion cysts can develop in several of the joints of the hand and wrist, including the lower part of the wrist, and also the joint at the end of a finger and at the base of a finger.

They vary in size and, in many cases, grow more with increased activity of the wrist. At rest, the size of the nodule is typically reduced.

It is not known what triggers the formation of a cystic tumor. These cysts are more common in young people between 15 and 40 years of age, and women are more likely to have them than men. They are also common among gymnasts, who repeatedly stress and overload the wrist.

A mucous cyst on the tip of the index finger.

Most ganglion cysts form a visible nodule, but smaller ones can remain hidden beneath the skin (hidden ganglion cysts). Although many ganglion cysts do not produce other symptoms, if a cyst puts pressure on the nerves that pass through the joint, it can cause pain, tingling, and muscle weakness.

The larger cysts, although not painful, may worry you as to their appearance.

Clinical history and physical examination

At the initial appointment, your doctor will discuss your medical history and symptoms. He or she may ask how long the lymph node has had, if it changes size and if it is painful.

Pressure could be applied to identify pain on palpation. Because a lymph node is filled with fluid, it is translucent. Your doctor may use a flashlight and light the cyst to see if light passes through.

Imaging tests

X-rays. These create transparent images of dense structures, such as bone. Although x-rays do not show a ganglion cyst, they can be used to rule out other conditions, such as arthritis or a bone tumor.

Explorations with magnetic resonance imaging (MRI) or ultrasound. These imaging tests can better show soft tissue, such as a ganglion cyst. Sometimes an MRI or ultrasound is needed to detect a hidden lymph node that is not visible, or to differentiate the cyst from other tumors.

Non-Surgical Treatment

During an aspiration procedure, fluid from the lymph node cyst is drained.

Reproduced with permission from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopedic Surgeons, 2010.

called aspiration.

The area surrounding the ganglion cyst is numbed and it is punctured with a needle so that the fluid can be extracted.

Aspiration often fails to remove the lymph node because the root or connection to the joint or tendon sheath is not removed. A ganglion cyst may be like a weed that will grow back if the root is not removed. In many cases, the lymph node reshapes after an aspiration procedure.

Aspiration procedures are most frequently recommended for cysts located in the upper part of the wrist. Your doctor may recommend surgery if your symptoms are not relieved by non-surgical methods, or if the lymph node cyst returns to normal. be formed after aspiration. The procedure for removing a lymph node is called a cleavage. The surgery involves removing the cyst and also part of the joint capsule or the sheath of the involved tendon, which is considered the root of the ganglion cyst. Even after excision, there is a small chance that the cyst will re-form.

A lymph node cyst on the wrist is removed during a surgical procedure called excision.

Excision is typically an outpatient procedure and patients can go home after a period of observation in the recovery area. There may be some pain on palpation, discomfort, and swelling after surgery. Normal activities can usually be resumed 2 to 6 weeks after surgery.

AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve medical advice. Anyone seeking specific orthopedic advice or assistance should consult his orthopedic surgeon, or locate one in your area through the AAOS "Find an Orthopedist" program on this website. The American Academy of Orthopedic Surgeons
9400 West Higgins Road in Rosemont, Illinois

The American Academy of Orthopedic Surgeons The American Academy of Orthopedic Surgeons in 9400 West Higgins Road in Rosemont, IL 60018
Phone: 847.823.7186 Email:

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