What is a Ganglion Cyst?
A Ganglion cyst is a cyst that appears along the tendons or joints of the hands. They may be accompanied by pain. While they are benign, they should be removed as there is no way to determine whether or not they are benign until they have been excised and sent to a lab for analysis. While they are primarily found at the wrist, they can also occur on the tendon sheath of the palm or finger and also at the DIP joint (which is the joint of the finger nearest the nail) which is known as a Mucoid cyst (associated with degenerative arthritis).
What causes a Ganglion Cyst?
The direct causes of a Ganglion cyst are unclear, but they are believed to be associated with specific sprains of the wrist and/or repetitive wrist motion.
What are the symptoms of a Ganglion Cyst?
In many cases, the Ganglion cyst will develop into a large lump on the wrist, highly visible and a clear indicator of the condition. This is not, however, always the case. It is just as likely that the cyst grows beneath the tendons of the wrist, so that it is not outwardly visible. The less visible a cyst, the more likely it is to cause pain, because of it’s position beneath so many levels and layers of hand anatomy, while the highly visible cysts, while dramatic in appearance, usually are less painful, as they are not entangled within the tendons.
How to diagnose a Ganglion Cyst.
For cases in which the cyst is clearly visible, diagnosis is fairly straightforward, but in cases where the cyst is beneath the surface of the wrist, MRI imaging is needed to determine the size and location. While X-rays are ineffective at detecting the cysts, they are still helpful to see if there is any underlying arthritis. MRI films are able to detect about 60% of Ganglion cysts.
Non-surgical treatment of a Ganglion Cyst.
As it is believed that Ganglion cysts develop and progress with activity, the first step is to immobilize as much as possible the affected wrist so that the cyst will stop growing, and possibly begin to shrink. Sometimes, this is enough to relieve the pressure on the nerves of the wrist, and stop the pain. Another non-surgical method that is often employed is aspiration, whereby the doctor will lance the cyst and drain it of fluid, thus effectively relieving the pressure and irritation. Aspiration, unfortunately, does not guarantee that the cyst won’t return, and some sources report that recurrence rate even after aspiration is up to 80%. Steroid injections, when paired with aspiration, may also help keep the cyst from recurring, but are not a definitive answer.
Surgical treatment of a Ganglion Cyst.
If non-surgical treatments are ineffective at reducing pain or inflammation, then usually it is necessary for the doctor to excise the cyst from your wrist. It is a simple surgery, and consists of the doctor making an incision in your wrist (of a size commensurate with that of the cyst), through which the cyst will be removed, along with its stalk and often some surrounding tissue. This is frequently performed with the assistance of wrist arthroscopy to minimize the incision size and to assess any additional injuries to the ligaments or cartilage of the wrist. The cyst will be sent to a pathology lab for testing, to make sure that it is a benign cyst. While there is no guarantee that a Ganglion cyst will not recur, the rate of recurrence following excision is only about 5%, far less than that accompanying aspiration.
How can Dr. Knight help you with a Ganglion Cyst?
Ganglion cysts are one of the most common wrist ailments, and throughout his career as a surgeon he has treated countless occurrences. His experience allows him to comfortably recommend the best possible treatment for a Ganglion cyst, one that both fits the patient and the condition.
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