Ganglion cysts of wrist and hand

These harmless lumps (fluid-filled cysts), which develop in joints in the hand (most often on the back of the wrist), are harmless and very often don’t require any treatment. They can vary in size and can become bigger, smaller or even disappear altogether.

Causes

Although no one is sure why they form, they are more common in women aged 15-40. They are especially common among gymnasts (perhaps due to extra stress on the wrist). However, ganglions that affect the end joint of a finger, which are more common in women aged 40-70, can be a sign of osteoarthritis.

Symptoms

These include a lump which can be painful if it puts pressure on nerves passing through the joint.

Diagnosis

Your specialist may press on the ganglion to assess how tender it is and ask you to explain the history of the problem, for example how long you have had the lump and whether it has changed size.

X-rays can rule out other problems such as osteoarthritis and MRI scans can show the ganglion clearly, ruling out other problems such as bone tumours, so the specialist can decide whether any treatment is necessary.

Treatment

Non-operative treatment: you may not need to have any treatment if the ganglion is not causing pain or problems with movement of the joint. However, you can wear a wrist brace if it’s interfering with your activities and this may help it to become smaller. You may also be given exercises to improve strength and flexibility. If the ganglion is interfering with your everyday life, your specialist may aspirate it. This involves having a local anaesthetic so the fluid can be drawn off the cyst with a fine needle. However, the ganglion can sometimes grow back.

Surgery: the ganglion can be removed along with its ‘root’, which is part of the joint capsule or tendon sheath. This can sometimes be done with Keyhole surgery (Wrist Arthroscopy). If you have surgery, most people are able to return to their normal activities within two to four weeks.

Important: This information is only a guideline to help you understand your treatment and what to expect. Everyone is different and your rehabilitation may be quic

This type of surgery is carried out to relieve nerve entrapment (cubital tunnel syndrome)
This procedure is used to release the ulnar nerve when it’s compressed at the elbow. The cubital tunnel sheath is cut and split into two, making the tunnel larger and releasing pressure on the nerve.
Arthroscopy allows surgeons to use a type of keyhole surgery to diagnose and treat joint problems.
Joint replacement is less common in the wrist than in other joints such as the knee or hip but can help if there is osteoarthritis or rheumatoid arthritis that has not improved with other treatments or surgery.
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