These fluid-filled sacs are the most common reason for a lump on the wrist or hand. They are non-cancerous but must be differentiated from cancerous lumps in the hand. The most common location is the back of the wrist or in the palm at the base of the fingers. At the wrist they arise from the joint and grow out of the lining of the wrist joint into the surrounding tissues; the fluid inside is similar to synovial or joint fluid, which lubricates the joints. They often appear and disappear suddenly and can change size. Many ganglion cysts do not need treatment. At times they become painful or interfere with function, such as wrist motion and gripping. They may also put pressure on a nerve, causing numbness and tingling.
No one knows what exactly causes ganglion cysts, but they are associated with injuries and overuse of the wrist and fingers and may indicate an underlying ligament injury in the wrist. Ganglion cysts are relatively common among gymnasts and other athletes who often experience unusual stress to their wrists. They occur more frequently in younger people between the ages of 15 and 40. There is a different form of a cyst, called a mucous cyst, that occurs on the dorsal aspect of the end of the finger over the end joint, and is associated with localized arthritis. These mucous cysts are more common in women between the ages of 40 and 70.
Since ganglion cysts may resolve on their own, the doctor may initially recommend simple, non-operative treatment. Immobilizing the affected joint to help it rest may also aid in decreasing the size of the cyst. Your doctor may also choose to aspirate the cyst by using a needle to remove the fluid so the lining walls can re-adhere. If the ganglion cyst returns or if conservative measures are unsuccessful, surgery is usually very successful. Ganglion cyst surgery is done as a simple outpatient procedure and takes less than an hour with patients usually resuming most activities within weeks.
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