GANGLIA (CYSTS OF THE WRIST)
A ganglion is a soft tissue mass. It is usually about 1-3cm in size but it may vary in time,
and even sometimes disappear spontaneously. Commonly, ganglion cysts grow on top of
the wrist (between the thumb and the radial artery – your pulse point), at the end joint of
the finger or at the base of the finger. They can also be located in other areas including
the knee, ankle or foot. A ganglion grows out of a joint, like a balloon between the
bones and the soft tissues. Inside the balloon is a thick, slippery fluid. Usually, the more
active you are the larger the ganglion grows; equally when you rest, it decreases in size.
No-one knows what triggers the formation of a ganglion. It is more common in women
than men and more common among people who apply stress to the wrist. It might also
be related to trauma.
Ganglions are not cancerous and they may disappear in time. If they don’t cause
significant discomfort, no treatment apart from observation is usually recommended
(provided that no radical changes occur). Sometimes ganglions may be painful. Large
ganglions, even if they are not painful are unattractive. The options of treatment are
aspiration or surgical excision.
A needle is put into the ganglion and the contents are removed. This is a simple
procedure but the recurrence rate is very high because it leaves the outer shell and the
stalk intact. Many surgeons do not use this method of treatment.
This is a straightforward procedure that is usually done as a day case under general
or regional anaesthetic. It requires an incision that is at least as long as the ganglion
itself and will leave a scar. Part of the involved joint capsule or tendon sheath may also
be removed. The ganglion may be sent to the laboratory for histology to confirm the
diagnosis. You should be able to resume activities in 2-6 weeks.
Confirmation of the diagnosis and removal of the swelling Relief from discomfort
• Wound infection may occur occasionally. If there are any signs of infection
(inflammation, discharge, warmth, increased pain around the wound) you should seek
• It may recur with embarrassing persistence.
• Pain may persist despite excision
• You may feel sensitivity around the scar
• You may experience injury to nerves, blood vessels or tendons
• You may experience joint stiffness
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