Ganglion Cysts of the Hand

Anatomy/Cause:

Dupuytren’s Contracture of the Hand

A ganglion cyst is the most common bump or mass on the hand/wrist. A ganglion cyst usually presents due to fluid from a tendon sheath or the joint leaking out to form the sac. These can be a result of trauma, tendon inflammation, arthritis, or for unknown reasons.

Diagnosis:

Typically, the diagnosis of a ganglion cyst can be made in the office by your provider. Sometimes, your provider may order an MRI if there are other complaints, or if the diagnosis is unclear, but this is usually unnecessary.

Treatment:

Nonsurgical Treatment

  • Observation, rest, or wrist brace: sometimes the cyst will go away on its own if you wait long enough. However, it is impossible to guess if and when this might happen!
  • Aspirating (draining) the ganglion cyst contents with a needle and syringe. This can be done in the office with lidocaine. It is very common that a cyst will return after draining the cyst, but this can be done as many times, and as often, as you wish. A recent meta-analysis in the Journal of Hand Surgery showed a 60% recurrence rate after aspiration.

Surgical Treatment
If your symptoms do not respond to the above non-operative treatments, surgery is your best chance at permanently removing the cyst. This is a same day surgery, and can be done asleep or awake. However, there is still a significant chance of recurrence even after surgery. A recent meta-analysis in the Journal of Hand Surgery showed a 20% recurrence rate, even after surgical excision!