INTRODUCTION

Ganglion cysts are noncancerous lumps that most commonly develop along the tendons or joints
of your wrists or hands. They also may occur in the ankles and feet. Ganglion cysts are typically
round or oval and are filled with a jellylike fluid.
Small ganglion cysts can be pea-sized, while larger ones can be around an inch (2.5 centimeters)
in diameter. Ganglion cysts can be painful if they press on a nearby nerve. Their location can
sometimes interfere with joint movement.
If your ganglion cyst is causing you problems, your doctor may suggest trying to drain the cyst
with a needle. Removing the cyst surgically also is an option. But if you have no symptoms, no
treatment is necessary. In many cases, the cysts go away on their own.

Symptoms
The lumps associated with ganglion cysts can be characterized by:

Location. Ganglion cysts most commonly develop along the tendons or joints of your
wrists or hands. The next most common locations are the ankles and feet. These cysts can
occur near other joints as well.

Shape and size. Ganglion cysts are round or oval and usually measure less than an inch
(2.5 centimeters) in diameter. Some are so small that they can't be felt. The size of a cyst
can fluctuate, often getting larger when you use that joint for repetitive motions.

Pain. Ganglion cysts usually are painless. But if a cyst presses on a nerve even if the
cyst is too small to form a noticeable lump it can cause pain, tingling, numbness or
muscle weakness.

Causes
No one knows exactly what causes a ganglion cyst to develop. It grows out of a joint or the
lining of a tendon, looking like a tiny water balloon on a stalk, and seems to occur when the
tissue that surrounds a joint or a tendon bulges out of place. Inside the cyst is a thick lubricating
fluid similar to that found in joints or around tendons.

Diagnosis
During the physical exam, your doctor may apply pressure to the cyst to test for tenderness or
discomfort. He or she may try to shine a light through the cyst to determine if it's a solid mass or
filled with fluid.
Your doctor might also recommend imaging tests such as X-rays, ultrasound or magnetic
resonance imaging (MRI) to rule out other conditions, such as arthritis or a tumor. MRIs and
ultrasounds also can locate hidden (occult) cysts.
A ganglion cyst diagnosis may be confirmed by aspiration, a process in which your doctor uses a
needle and syringe to draw out (aspirate) the fluid in the cyst. Fluid from a ganglion cyst will be
thick and clear or translucent.

Complications
Having a ganglion cyst removed is a minor procedure, so complications are rare and seldom
serious. However, a small number of people experience permanent stiffness and pain after
surgery.
If you have the operation under general anaesthetic, there's also a very small risk of
complications to your heart and lungs. Pre-assessment tests before surgery should make sure
your risks are as low as possible.
There's always a chance a ganglion cyst will come back after treatment. This is more likely if the
ganglion is on certain areas of the wrist.

Treatment
Ganglion cysts are often painless, requiring no treatment. Your doctor may suggest a watch-andwait approach. If the cyst is causing pain or interfering with joint movement, your doctor may
recommend:

Immobilization. Because activity can cause the ganglion cyst to get larger, it may help to
temporarily immobilize the area with a brace or splint. As the cyst shrinks, it may release
the pressure on your nerves, relieving pain. Avoid long-term use of a brace or splint, which
can cause the nearby muscles to weaken.

Aspiration. In this procedure, your doctor uses a needle to drain the fluid from the cyst.
The cyst may recur.

Surgery. This may be an option if other approaches haven't worked. During this
procedure, the doctor removes the cyst and the stalk that attaches it to the joint or tendon.
Rarely, the surgery can injure the surrounding nerves, blood vessels or tendons. And the
cyst can recur, even after surgery.

Next Steps Follow-up

After you have been diagnosed with a ganglion cyst and have chosen to have treatment, follow-up will be
different based on what you have chosen to do.
After simple aspiration, your doctor may ask you to start moving the joint soon after the procedure.
Most likely after surgery, your joint will be splinted for up to 7 to 10 days. A splint is a hard wrap that will
keep you from moving your joint.
Recent studies show that splinting for a long period of time doesn't really help, and use of the joint soon
after treatment is being encouraged.
Your doctor may ask you to return for a check-up after your surgery and will decide if physical or
occupational therapy is needed. Follow-up care will be based on your personal needs.
Prevention
Because the cause of a ganglion cyst is not known, it is difficult to tell how to prevent them. Early
evaluation and treatment are recommended.