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Ganglion Cyst

Overview

A ganglion cyst is a fluid-filled bump, usually located around a joint or tendon sheath in the hand, wrist or foot. They are the most common soft tissue mass of the hand and wrist, affecting 55 out of every 100,000 people each year.

Ganglion cysts are three times more common in women than men, and can arise at any age. There does not appear to be any relationship between ganglion cysts and dominant hand or occupation.

Our approach to ganglion cyst

Ganglion cysts do not need treatment unless they're causing symptoms, and many go away on their own. If a cyst becomes infected or painful, or starts to interfere with movement, a doctor can drain the fluid inside or remove the cyst surgically.

Should you need treatment, our team includes highly trained surgeons who specialize in the hand and wrist, where most ganglion cysts occur. We also have surgeons who specialize in the foot and ankle, other common sites for these cysts.

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Signs & symptoms

The vast majority of ganglion cysts arise as small, painless bumps ranging from 1 to 3 cm in size. Most have a firm or rubbery consistency. Occasionally, the cysts cause symptoms. The most common symptoms include:

  • Pain. Typically, the pain is dull and persistent and gets worse at the extremes of wrist motion. More frequently, pain is associated with dorsal ganglion and smaller ganglion size.
  • Weakness. Sometimes, a ganglion cyst puts pressure on the nerves that pass near the joint. This may weaken hand strength, affect joint motion or cause tingling in the fingers, hand or forearm.

Diagnosis

Doctors are often able to diagnose a ganglion cyst based on its appearance and location. In addition, because the fluid inside a ganglion cyst is translucent, the doctor may hold a flashlight to the cyst to see if light shines through. Your doctor may also remove the cyst fluid to confirm the diagnosis.

X-rays are often reserved for cases in which other conditions, such as osteoarthritis, bone spurs, bone tumors or fractures, are suspected. However, X-rays may also be used to determine if there is cyst-related damage to wrist bones.

Treatments

Most ganglion cysts will disappear without any treatment, and the cysts often return despite treatment. If the cyst is not painful and does not interfere with function, often all that is needed is education, reassurance and management. More aggressive treatment is indicated if a ganglion cyst starts to cause symptoms, gets infected, or is affecting adjacent bones or ligaments. Treatment options include:

  • Aspiration. A large, 16 gauge needle is used to aspirate the cyst. This is rarely a permanent solution. In one study with 34 patients, 59 percent of cysts reoccurred within three months.
  • Aspiration with a steroid injection. This is the most commonly used approach and is thought to be more effective than aspiration alone. Studies have shown cure rates ranging from 57 to 79 percent with this approach.

UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.

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