Ganglion cysts are common swellings typically located around the wrist joint or finger joints or tendon sheaths. They contain a thick gel-like fluid. They often arise spontaneously or sometimes it is a result of an injury or arthritis. The majority just lead to a visible swelling, but sometimes the lump can cause discomfort and interfere with daily activities.
Sometimes are not needed but range from xrays to ultrasound to MRI depending on the history.
Around 2/3rds of ganglions will disappear on their own. Even if it does not, it is completely harmless and does not necessarily need treatment.
If treatment is required, the most successful treatment is surgical excision. Depending on the situation, surgery to address the underlying arthritis may be performed at the same time.
Occasionally needle aspiration is considered but only gives short term deflation of the lump.
Postoperative risks and complications:
Swelling and stiffness – keep your hand raised and exercise your fingers and wrist to prevent this
Scars – will be firm and lumpy initially, and sometimes sensitive, but with regular scar massage will fade and soften with time
Recurrence – around 10%, higher if there is an underlying joint problem like arthritis
Ongoing discomfort at site of ganglion
Complex Regional Pain Syndrome (CRPS) – a complication of any upper limb surgery (<5%), which is unpredictable and causes swelling, stiffness and pain. This is treated with different Hand Therapy techniques.