Ganglion Cyst:

A ganglion cyst is an out pouching of the joint capsule typically around the wrist. The joint capsule is a layer of tissue that surrounds a joint and keeps the lubricating fluid of the joint in the joint. A ganglion can appear on the palmar or back of the wrist (Figure 1). Typically they are soft and compressible, but they can be quite firm. These masses are actually fluid filled sacks and can vary in size over time. A ganglion cyst is not a tumor. In adolescents, these ganglions are from unknown causes. If they are found in more mature patients, it is typically associated with mild to moderate arthritis in the joint in which it is associated.

Typically the diagnosis can be mad based on the feel and location of the mass. If there is concern, a MRI may be required to confirm the diagnosis. Once the diagnosis is confirmed, treatment for ganglion cysts can be multiple. Observation can be used unless the mass becomes bothersome. The fluid can be aspirated, but in many instances the sack can refill. Definitive treatment requires complete surgical excision (Figure 2). Excision requires tracing the cyst back into the joint.

Postoperative recovery includes splinting for approximately 2 weeks. Stiffness and pain can be expected for up to six weeks to even 3 months after surgery.

Figure 1 Figure 2