What are Ganglion Cysts?

Lumps and bumps on the hand, wrist, or forearm can be a cause of significant anxiety for patients but are rarely anything too serious. Benign cysts and masses are actually very common in the hand and wrist, and often don’t cause significant problems. They can however sometimes cause pain or limit function. Malignant or cancerous tumors of the hand, wrist, or forearm are exceedingly uncommon, but we recommend you have any new lump or bump checked out.

Ganglion cysts are very common benign fluid-filled cysts that usually occur near joints or tendons.

Illustration of a Ganglion Cyst

Causes

The cause of most ganglion cysts is unknown. Occasionally there is a history of injury to the area. Mucous cysts that occur near the fingernails are usually associated with osteoarthritis of the adjacent joint. Wrist ganglion on the other hand often occur in young patients without history of wrist injury.

Symptoms

Ganglion cysts often begin as painless lumps under the skin but may start to ache or inhibit joint motion as they grow over time. Wrist ganglion may fluctuate in size. Mucous cysts which occur around the fingernails sometimes become thin and blister-like and can rupture with minor trauma. Seed ganglion in the palm often feel hard and are quite tender to touch.

Ganglion cyst on the top of the wrist

Common Ganglion Cyst Locations:

Fingers:  Around the joint at the base of the fingernail (mucous cysts)
Palm:  Around the pad of the palm / base of fingers (seed ganglion)
Wrist:  Palm/thumb side of wrist (volar wrist ganglion) and back/center of wrist (dorsal wrist ganglion)

Illustration showing locations where ganglion cysts may form

Is there a test for Ganglion Cysts?

Yes! X-rays can detect bone healing and alignment, but signs of healing can be subtle for some types of fractures. Sometimes CT scans are ordered if bone healing is questionable. Your symptoms can also be a clue, as fractures with healing problems tend to hurt longer than expected.

When should you be more concerned about lumps and bumps?

All new or changing lumps and bumps should be checked out. Even benign ones can be painful or limit function and may benefit from simple treatments. Severe pain, rapid growth, and skin ulcerations definitely warrant more urgent medical attention.

When should you be more concerned about lumps and bumps?

All new or changing lumps and bumps should be checked out. Even benign ones can be painful or limit function and may benefit from simple treatments. Severe pain, rapid growth, and skin ulcerations definitely warrant more urgent medical attention.

Treatment

Treatment options depend on the type and location of the cyst or mass, and whether it is symptomatic.

Illustration highlighting Ganglion Cyst treatment options

Nonoperative treatment:

Simple cysts or masses can often just be observed if they are not painful, limiting function, or growing. Some fluid-filled cysts like wrist ganglion cysts can often be drained in the office.

Operative treatment:

Painful cysts or masses, those that are limiting function, or those that show concerning features like rapid growth can often be surgically removed. The biopsy tissue can be sent to the lab for identification if the diagnosis is questionable. When should you be more concerned about lumps and bumps?

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