Ganglion Cysts

Overview

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A ganglion cyst is a sometimes painful lump that develops on the top or underside of the wrist or at the base of a finger. The problem is evaluated and treated by hand specialists in the Department of Orthopedic Surgery.

A ganglion grows out of a joint like a balloon on a stalk. Inside the balloon is thick, slippery fluid similar to that found in joints. The lump often gets bigger with constant, strenuous use of the hand and shrinks at rest. Sometimes the cyst disappears on its own.

Even when small, a ganglion cyst can be quite painful if it presses on nerves. Even if it does not hurt, a large one may be cosmetically unappealing. An X-ray is usually taken to rule out arthritis or a bone tumor. Sometimes an MRI or ultrasound scan is done to find a small ganglion hidden under the skin.

If the cyst is not painful, treatment may consist of nothing more than waiting and watching. A brace or splint may be recommended to immobilize the wrist and reduce swelling. If the cyst is large or painful, fluid may be drained from it with a fine needle after first numbing the skin. However, the cyst and stalk are still there and can refill with fluid.

Surgery may be recommended if the other treatments fail. Surgery is done as an outpatient procedure. During surgery, the cyst, along with a small amount of surrounding tissue, is removed. There may be tenderness, discomfort and swelling at the site following surgery, but normal activities can usually be resumed in two to six weeks. Surgery offers the best chance of removing the ganglion, but the cyst may return.