Ganglion cyst

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Ganglion cyst
A ganglion cyst on the wrist
Synonyms	Bible cyst, Bible bump
Pronounce	N/A
Specialty	N/A
Symptoms	Swelling, pain, numbness
Complications	Nerve compression, restricted movement
Onset	Any age, most common in young adults
Duration	Variable, can be chronic
Types	N/A
Causes	Unknown, possibly joint or tendon irritation
Risks	Repetitive strain, joint injury
Diagnosis	Physical examination, ultrasound, MRI
Differential diagnosis	Lipoma, epidermoid cyst, tenosynovitis
Prevention	N/A
Treatment	Observation, aspiration, surgery
Medication	NSAIDs for pain
Prognosis	Generally good, may recur
Frequency	Common
Deaths	N/A

A ganglion cyst is a noncancerous lump that often develops along the tendons or joints of the wrists or hands, but may also appear on the feet. These fluid-filled cysts can quickly appear, disappear, and change size, causing distress or fascination more than pain or functional limitation.

Etiology and Pathophysiology

The exact etiology of ganglion cysts is unknown, but they may arise from trauma, chronic tissue irritation, or degenerative changes in the surrounding joint or tendon. The cyst forms when the tissue surrounding a joint or tendon bulges out, filling with a thick, clear fluid similar to synovial fluid.

Clinical Presentation

Most ganglion cysts are round or oval and are typically 1-3 centimeters in diameter. They are usually soft and mobile, with a consistency similar to a rubber ball. While many ganglion cysts are asymptomatic, some can cause pain, especially after acute or repetitive trauma. They may also interfere with joint movement.

Diagnosis

Diagnosis of a ganglion cyst is typically made through a combination of medical history, physical examination, and imaging studies. Ultrasonography and magnetic resonance imaging (MRI) can help confirm the diagnosis and rule out other potential causes of the lump, such as a tumor.

Treatment

• Treatment of ganglion cysts is often unnecessary, as they may resolve spontaneously. If the cyst causes pain or limits activity, however, treatment options include:
• Immobilization: Activity often causes the ganglion cyst to increase in size, thus increasing pain. Immobilization can cause the cyst to decrease in size.
• Aspiration: This involves using a needle to remove the cyst's fluid. However, cysts recur in the majority of patients following this treatment.
• Surgery: This is usually reserved for painful cysts that have not responded to other treatments or if the diagnosis is uncertain. The recurrence rate after surgical removal is much lower than that after aspiration.

Prognosis

The prognosis for a ganglion cyst is generally good, although recurrence is common. The cysts are not cancerous and do not pose a risk for malignancy.

See Also

• Cyst
• Rheumatology
• Orthopedics

References

• Suen M, Fung B, Lung CP. (2013). Treatment of Ganglion Cysts. ISRN Orthopedics. doi:10.1155/2013/940615.
• Thornburg LE. (1999). Ganglions of the hand and wrist. Journal of the American Academy of Orthopaedic Surgeons, 7(4), 231-238.
• Dias J, Buch K. (2016). The natural history of untreated dorsal wrist ganglia and patient reported outcomes 6 years after intervention. Journal of Hand Surgery (European Volume), 41(7), 745-750.

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