Ganglions cysts are benign soft tissue lumps that occur in the hand and wrist. They can occur at several locations, most commonly on the back of the wrist. Less common locations include the front of the wrist, the front of the fingers and the back of the last joint of the fingers.

Incidence/age

Ganglion cysts are the commonest soft tissue lump in the hand and wrist. These lumps account for one-third to two thirds of all hand lumps. Ganglions are more common in women and generally occur (70%) between the second and fourth decades of life.

What causes gaglion

The cause of ganglion cysts is obscure. These cysts arise in association with the joints of the hand, the tendon sheath of the finger and rarely within bone. Most ganglion cysts appear gradually but some patients report that the cyst appeared acutely following a hand injury.

Signs/symptoms

Patients often complain of pain in the wrist or hand associated with ganglion cysts. The cyst itself is sometimes tender to pressure. The cyst produces a visible swelling and many patients are unhappy with the cosmetic appearance. These cysts are soft and can be squashed. The cyst is slightly mobile and light-up brightly if a small light source is placed against it.

Complications of disorder

There are no significant complications of the ganglion itself. No tests are necessary to diagnose the vast majority of ganglia. Occasionally ganglia may lie deep in the hand, or elsewhere in the upper limb. These ganglia may produce symptoms but be difficult to diagnose. The doctor may order special scans, CT and MRI, to diagnose ganglia in these situations.

Treatment

Non-operative: Most ganglia require no treatment. An explanation of the condition and assurance that it is non-malignant is often the only treatment sort or required. The old wives remedy of hitting the ganglia with the family bible may be temporarily effective! All non-surgical methods have limited success and a significant recurrence rate. However, they are simple to perform and reduce the swelling, albeit temporarily. Non-surgical treatment involves placement of a large needle into the ganglion cyst and aspirating its contents. Some surgeons then inject the ganglion with local anaesthetic agents or steroids.

Surgical treatment: Surgical treatment of ganglia is best reserved for patients with persistently symptomatic lesions

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