Ganglion Cysts of the Hand
WHAT IS A GANGLION CYST?
Ganglion cysts arise from a tissue called synovium located in the capsule of a joint or the sheath of a tendon. Many different places on the wrist contain synovium and ganglion cysts can form in numerous places along the wrist and hands with varying degrees of inconvenience. The most common growth on the hands and wrist, in the fingers the name changes to mucous cysts, ganglion cysts can range from unseen, annoying, painful, irritating, embarrassing, to dangerous because of the pressure they can exert on the blood supply in certain locations. The interior of the ganglion cyst consists thick, often sticky, translucent, colorless, jelly-like substance called synovial fluid. Synovial fluid naturally occurs in the capsules of joints and tendon sheaths with the purpose of lubricating the mobile tissues. Depending on the exact size, the cyst may feel tight, firm or even spongy. A dorsal ganglion cyst grows on the top of the wrist, and a volar ganglion cyst grows on the underside of the wrist. Ganglion cysts grow from the same tissues, have the same composition, and terms like volar and dorsal only exist to convey locational information. Ganglion cysts can manifest anywhere tendons run or joints exist, but most often a ganglion cyst will grow between the thumb and the pulse point in the wrist, at the end joint of a finger, or at the base of the finger where it meets the hand. Ganglion cysts rarely need intervention and will dissipate harmlessly over time. If the ganglion cyst is pressing on a nerve causing pain, inhibiting the use of a joint, threating the flow of blood into the hand, or if the ganglion cyst does not resolve over time, a surgeon will consider the cyst appropriate to surgically remove with an open or arthroscopic surgery.
WHAT ARE THE SYMPTOMS OF A GANGLION CYST?
If the fluid-filled sac, called a ganglion cyst, puts pressure on the nerves that pass through the joint the cyst can potentially cause significant pain. Large ganglia, even if they are not painful, cause negative emotions in some patients by making them feel unattractive; patients put in emotional duress by a prominent ganglion cyst do get consideration by the surgeon and insurance company for removal. Smaller ganglion cysts that remain hidden under the skin (occult ganglions) may require an MRI or ultrasound to detect the source of the patients difficult to diagnose hand or wrist pain. A ganglion grows out of a joint, like a balloon on a stalk. It rises out of the connective tissues between bones and muscles and can create a quite prominent lump. The interior of the cyst’s composition of slippery fluid, called synovial fluid, exists naturally in your joints and tendon sheaths. Usually, the more active the wrist, the larger the cyst becomes. With rest, the lump can decrease in size over time. Ganglion cysts may rupture but have a large rate of incidence of growing back without surgical removal. If on the finger, it may require a mucous cyst excision.
