What are Mucous 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. Mucous cysts are just a particular type of ganglion cysts that occur around the finger joint around the base of the fingernails.

Causes

Mucous cysts that occur near the fingernails are usually associated with osteoarthritis of the adjacent joint.

Symptoms

Mucous cysts often look like small smooth warts or blisters on the skin near the base of the fingernails. Large cysts occasionally rupture with minor trauma producing a thick clear jelly like substance. The cysts may also press on the nail bed producing a split or crease in the fingernail over time. Occasionally these cyst rupture (or are deliberately punctured) resulting in serious infection with increased pain, swelling, redness and pus drainage.

Is there a test for Mucous Cysts?

Your symptoms and medical history as well as an examination of your hand can usually confirm a diagnosis of mucous cyst. X-rays are often obtained to evaluate for commonly associated osteoarthritis and bone spurs.

When should you be more concerned about mucous cysts?

Mucous cysts that are enlarging, painful, or causing significant fingernail deformities should be evaluated. If the cyst ruptures or is deliberately punctured, a serious infection can result that can damage the finger joint (septic joint arthritis) and even cause a bone infection (osteomyelitis). Pending cyst ruptures or suspected infections (redness, swelling, pus) need urgent evaluation.

Treatment

Treatment options depend on the size of the mucous cyst, and how symptomatic it is.

Nonoperative: Simple mucous cysts can be observed or drained with a sterile needle in the office. Recurrence is common however.

Operative: Large cysts, or those with impending rupture should be removed surgically. Often there are underlying bone spurs that can be removed to reduce the risk of recurrence. Very large cysts sometimes require a small skin graft or skin advancement to fill the hole from removing the cyst.

Infected cysts require urgent surgical drainage and antibiotic 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