Ganglion cysts are benign soft tissue tumors that most frequently occur around the dorsum of the wrist and on the fingers, although any joint can be affected. They can present as a swelling or as joint pain. Ganglion cysts are most common in patients aged 20-40 years but may affect any age group.
They usually present as cosmetic concerns but may uncommonly have associated neurologic or vascular symptoms. If the cyst compresses an underlying nerve, the patient may report distal numbness or weakness. Vascular compression may cause coolness or cyanosis of areas distal to the cyst. The size of the cyst may vary over time and can increase after activity.
Although the exact etiology is unknown, it is likely that a small tear forms in a joint capsule or tendon sheath, allowing extravasation of synovial fluid into the adjacent tissue. When the fluid reacts with local tissue, it becomes more gelatinous and a cyst wall forms. While it has been postulated that ganglion cysts are caused by chronic joint inflammation, this theory is less likely because inflammatory changes are not seen in ganglion cysts.
Lipoma – A freely movable, soft, fluctuant mass that does not transilluminate.
Giant cell tumor of the tendon sheath – A firm, fixed swelling generally occurring on the flexor surfaces on the tendons in the region of the hand; does not transilluminate.
Tenosynovitis – Diffuse swelling and bogginess of the tenosynovium overlying a tendon; usually tracks along the tendon in a longitudinal fashion.
Neuroma – Less mobile and does not transilluminate.
Soft tissue sarcoma (eg, fibrosarcoma) – Less mobile and typically not well circumscribed.
Gouty tophus – A hard, nodular mass commonly found around the fingers, at the tips of the elbows, and around the big toe.
Osteosarcoma – Immobile and not well circumscribed.
Septic arthritis – Typically presents as an erythematous, warm, swollen joint; an effusion can often be detected.
Artery aneurysm – Pulsatile, and a thrill may be palpated.
A ganglion cyst is a noncancerous, fluid-filled growth that commonly develops on the tendons or joints of your wrist, fingers, or hand. However, one can occur on any Joint, such as in the ankle or the top of your foot. Ganglion cysts can range from the size of a pea to just under an inch in diameter. They often cause swelling or joint pain and can limit movement of the joint. The cause of ganglion cysts is unknown.
Who’s At Risk
Women aged 20-40 are most commonly affected, but people of any age, male or female, can get a ganglion cyst.
Risk factors for ganglion cysts include:
Previously injured finger joints
History of arthritis in the finger joints
Signs & Symptoms
Ganglion cysts are round and usually smaller than an inch. They are often painless, but if the cyst is near a nerve, it can cause pain, numbness, or muscle weakness.
Self-Care Guidelines
To relieve pain, over-the-counter medication is recommended. Ibuprofen (Advil, Motrin IB) or naproxen sodium (Aleve) can help reduce symptoms.
Patients are cautioned not to drain the cyst on their own or to attempt to break it open due to possible infection and tissue damage.
When to Seek Medical Care
Contact your health care provider if you develop what you believe is a ganglion cyst. Even if the cyst is painless, a medical professional should look at it to rule out other potential diseases.
Treatments
Ganglion cysts usually require no treatment. Your health care provider may recommend waiting to see if it goes away on its own.
Immobilization is a technique of splinting or bracing an affected joint to prevent its movement for a limited time. This can cause the cyst to decrease in size. However, inactivity of joints and muscles can cause loss of muscle mass and long-term damage to muscle and joint strength.
Aspiration is another technique used for treating ganglion cysts. The health care provider inserts a needle into the cyst to drain the fluid. More than half of fluid aspirations result in recurrence within a year. Some cysts will clear on the second aspiration.
Patient Information for Ganglion cyst