A Ganglion is a cyst made of excess fluid from a joint or tendon, and is extremely common around the hand and wrist. They are a sign of (usually) mild inflammation in the underlying area. They often occur on the top or underside of the wrist, at the base of the finger in the palm and in the last finger joint by the nail. They are usually painless, but can be tender and occur from the bodies response to the underlying inflammation. They do not imply anything sinister.
Our consultant’s will listen to your symptoms and history, and examine your wrist and hand. They may also shine a light through the ganglion which should lights up evenly. Sometimes an X-ray may be taken to identify the underlying cause of the inflammation and an ultrasound may be performed.
Treatment options
Watch and wait: Most ganglia resolve by themselves, although this can take time (up to 5 years).
Aspirate or burst: If the ganglia is uncomfortable it can be aspirated, or if small it is burst. A steroid injection is sometimes given to aid with the inflamed area.
Surgery: The cyst is exposed and removed, the “neck” of the cyst is then widened which reduces the risk if it returning and the skin is sutured with absorbable stiches. Recurrance of a ganglion after surgery is as follows:
Dorsal wrist (back of wrist): 24%
Volar wrist (under side of wrist): 30-40%
Mucous cyst: Few
Removal of seed ganglions can be achieved through a technique pioneered at The Hand to Elbow clinic, which involves releasing the underlying tendon with a needle through the skin, resulting in up to 85-90% satisfaction.
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