Ganglion
cysts (ganglia)
Definition
Ganglions cysts are benign soft tissue lumps that occur
in the hand and wrist. They can occur at several locations,
most commonly on the back of the wrist. Less common locations
include the front of the wrist, the front of the fingers
and the back of the last joint of the fingers.
Incidence/age
Ganglion cysts are the commonest soft tissue lump in the
hand and wrist. These lumps account for one-third to two
thirds of all hand lumps. Ganglions are more common in women
and generally occur (70%) between the second and fourth
decades of life.
Causes
The cause of ganglion cysts is obscure. These cysts arise
in association with the joints of the hand, the tendon sheath
of the finger and rarely within bone. Most ganglion cysts
appear gradually but some patients report that the cyst
appeared acutely following a hand injury.
Signs/symptoms
Patients often complain of pain in the wrist or hand associated
with ganglion cysts. The cyst itself is sometimes tender
to pressure. The cyst produces a visible swelling and many
patients are unhappy with the cosmetic appearance. These
cysts are soft and can be squashed. The cyst is slightly
mobile and light-up brightly if a small light source is
placed against it.
Complications
of disorder
There are no significant complications of the ganglion itself.
No tests are necessary to diagnose the vast majority of
ganglia. Occasionally ganglia may lie deep in the hand,
or elsewhere in the upper limb. These ganglia may produce
symptoms but be difficult to diagnose. The doctor may order
special scans, CT and MRI, to diagnose ganglia in these
situations.
Treatment
Non-operative: Most ganglia require no treatment. An explanation
of the condition and assurance that it is non-malignant
is often the only treatment sort or required. The old wives
remedy of hitting the ganglia with the family bible may
be temporarily effective! All non-surgical methods have
limited success and a significant recurrence rate. However,
they are simple to perform and reduce the swelling, albeit
temporarily. Non-surgical treatment involves placement of
a large needle into the ganglion cyst and aspirating its
contents. Some surgeons then inject the ganglion with local
anaesthetic agents or steroids.
Surgical treatment: Surgical treatment of ganglia is best
reserved for patients with persistently symptomatic lesions
(see ganglion surgery)
