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What are Ganglion Cysts

Ganglion cysts are swellings (lumps) that most commonly develop along the tendons or joints of wrists or hands. They can be found either at the top of the wrist, palm side of the wrist, end joint of a finger or at the base of a finger. A ganglion cyst is not cancerous and will not spread to the other parts of the body. It looks like a water balloon on a stalk and contains a clear fluid or jelly material. Ganglion cysts can be found in people of all ages.

Causes of Ganglion Cysts

Although the exact cause of a ganglion cyst remains unknown, some theories suggest that small cysts are formed when trauma damages the tissue of a joint. The most likely reason might be that these cysts occur because of a defect in the joint capsule or tendon sheath that permits the joint tissue to bulge outwards.

Signs and Symptoms of a Ganglion Cyst

Ganglion cysts generally appear as a mass measuring from 1 to 3 centimeters in diameter. The swelling is usually soft and immobile. It may develop suddenly or gradually over time, vary in size or even disappear or reappear.

A ganglion cyst may or may not be painful. If painful, the pain may be continuous and worsen with the movement of the joint. If the cyst is attached to a tendon, one might feel weak in the affected area.

Diagnosis of a Ganglion Cyst

Dr. Miller will diagnose a ganglion cyst by performing a physical examination. The diagnosis is confirmed by needle aspiration or ultrasound. Needle aspiration is a process where some amount of the fluid in the cyst is withdrawn using a sterile needle. An ultrasound imaging can reveal whether the lump is solid or fluid-filled (cystic). It can also determine if an artery or blood vessel is causing the lump. Magnetic resonance imaging (MRI) of the wrist may also be ordered to diagnose ganglion cysts especially in the case of occult ganglions which are sometimes to small to visualize on the ultrasound. Dr. Miller is skilled at the use of Ultrasound to make the diagnosis and when needed to guide the needle for drainage.

Treatment of a Ganglion Cyst

In some cases, these cysts may disappear without any treatment. Aspiration is performed by using a needle to drain the fluid from the cyst. In the case of an occult ganglion (too small to drain effectively) steroid injection may be offered. If the cyst becomes painful or limits your activity, causes numbness or tingling of the hand or fingers, your doctor may recommend surgery to remove the ganglion cyst. This is a quick procedure that has over 90 to 95 percent chance of permanently resolving the cyst. Recurrence rates of 5-10 percent after surgical excision are often quoted in the literature. Post surgical management includes wearing the post op splint for one week then range of motion is started. Therapy is not typically needed. Weight bearing exercises are usually tolerated 3-4 weeks after surgery.

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