Ganglion Cyst

Ganglion Cysts – Lump like Fluid Filled Swelling

Ganglion cysts is a very common lump like a fluid filled swelling which tends to develop near a joint or a tendon and can vary in size from a pea to the size of a golf ball. The most common areas are the top of the wrist, palm side of the wrist, base of the finger on the palm side and the top of the end joint of the finger.

 It often appears like a water balloon on a stalk which is filled with clear fluid or gel known as synovial fluid which surrounds the joints and tendons in order to lubricate and cushion them during movement and is generally harmless though they can at times be painful especially if it is located next to a nerve. If they are not painful or cause any discomfort, it could be left untreated and may disappear without any treatment though it could take a number of years.

The formation of ganglions is not clear though it could be related to age or injury to the joint or tendon and occurs when the synovial fluid surrounding the joint or tendon leaks out and collects under the skin.

Cysts not Cancerous 

The cysts may change in size, are not cancerous and will not spread to other parts of the body. Diagnosis depends on the location of the cysts and its appearance which is usually oval or round and could be soft or very firm.

The cysts which are at the base of the finger on the palm area are very firm, the size of a pea which are tender to applied pressure while gripping and light tends to pass through these lumps which can help in the diagnosis. Cysts at the far joint of the finger often have an arthritic bone shoot linked with them and the overlapping skin could be thin with lengthwise groove in the fingernail beyond the cyst.

Treatment is often recommended only if the cyst may cause pain or it may affect the range of movement in a joint and the two main options of treatment for ganglion cysts comprises of draining of fluid out of the cyst with a needle and syringe known as aspiration in medical term or cutting the cyst out through surgery. Aspiration is a simple process and recurrence of the cyst is very common.

Treatment – Surgical/Non-Surgical

Treatment could also be non-surgical and in several cases, the cysts can be observed if they are not painful since they tend to disappear within a period of time. If they tend to be painful, limits activity, several other options are available like the use of splints and anti-inflammatory medication may be prescribed to relieve the pain linked with activities.

If non-surgical treatment does not provide relief or if the cyst recurs, surgical alternative are available and the surgery involves the removal of the cyst along with a part of the joint capsule or tendon sheath. With regards to wrist ganglion cysts, traditional open and arthroscopic techniques tend to provide good results and surgical treatment is often successful though they cysts may reappear.

Both the techniques can be performed under either local or general anaesthetic depending on the area of the ganglion and which anaesthetic one would prefer and what is recommended by the surgeon.