Bone Spurs and Cysts

Bone spurs are sharp spikes of bone that form at the margins of joints with arthritis. Sometimes you can actually fell the bone spur as a hard lump under the skin. Bone spurs can happen on wrists, hands, thumbs, and on other joints.

Bone cysts are just small holes or cavities that form inside the bone around arthritic joints. They also sometimes form spontaneously in healthy bone. These can’t be felt but are detectable on x-ray.

Illustration of Osteoarthritis in the hand causing pain and stiffness.Arthritis literally means “inflamed joint”, and generally refers to any damage to the joints of the body. There are 36 joints in the hand and wrist, and several sites that commonly affected by arthritis. Osteoarthritis is the most common type and is a degenerative breakdown of the joints over time. The CMC joint at the base of the thumb is commonly affected. Less common forms of arthritis include damage to the joint due to injuries (post-traumatic arthritis), and inflammatory arthritis (rheumatoid, gout, psoriatic).

Causes

Bone spurs and cysts commonly occur in association with the various types of joint arthritis.

Signs and symptoms

While the arthritic joint may hurt, the bone spur or cyst is usually not what is causing the pain. Occasionally a prominent bone spur on your hand, wrist, or thumb can put pressure on the skin or irritate an overlying tendon, causing pain or a snapping sensation. Prominent bone spurs may also cause a visible lump under the skin. which is hard to the touch and not mobile like a ganglion cyst would be.

Is there a test for bone spurs and cysts?

X-rays of the hand and wrist can generally detect significant bone spurs and cysts, which may also serve as evidence of arthritis of the joint. A physical exam can reveal some large bone spurs. 

thumb x-ray with IP (interphalangeal) bone spurs  x-ray of fingers with distal interphalangeal arthritis
Photo left: Thumb x-ray with IP bone spurs
Photo right:  X-ray of fingers with distal interphalangeal (DIP) arthritis

Treatment

Treatment for bone spurs and cysts is usually the same as treatment for the associated arthritis. Occasionally a bone spur may be large or symptomatic enough to warrant surgical removal. Bone cysts rarely require individual treatment.  

Ready to confirm a diagnosis and fix the problem, or just want to learn more?

Our board-certified orthopedic hand and wrist surgeons, Eric Angermeier, MD and Kyle Kokko, MD, PhD, are here to help! They can often diagnose the problem in one visit, and get you started with a treatment plan. We offer a wide variety of both nonoperative and operative treatment options.

Call today for a clinic or telehealth appointment! 854-429-4263