Ganglion Cyst

Ganglion cysts are usually classified based on their location:

• Wrist ganglion cysts are the most common and usually appear on the back (dorsum) of the wrist.
• Foot and ankle ganglion cysts are less common but may interfere with walking.
• Flexor tendon sheath cysts occur at the base of the fingers and may cause pain when gripping.

People with ganglion cysts may notice the following:

• A soft painless swelling, most often on the back of the wrist.
• A dull aching pain when moving the wrist to its full range.
• Tingling, numbness, or muscle weakness if the cyst presses on a nearby nerve.

Certain factors make some people more likely to develop ganglion cysts:

• Women are more commonly affected.
• People between the ages of 15 and 40 are at a higher risk.
• Repetitive movement or friction, such as those in gymnastics or other activities, can increase the chance of cyst formation.

One or more of the following methods may be used to diagnose ganglion cysts:

• Physical examination: This helps identify the swelling.
• Radiography (X-ray): This helps assess the condition of the joint and rule out other conditions.
• Ultrasonography or magnetic resonance imaging (MRI): This helps to can help confirm the diagnosis and the size and location of the cyst.
   

Treatment depends on symptoms and how much the cyst affects daily activities:

• Non-surgical treatment: 
  • Observation is often enough if the cyst is painless and does not interfere with movement.
  • A wrist brace or splint may be used to rest the joint, reduce pain, and decrease swelling.
  • Aspiration (draining fluid from the cyst with a needle) may be done if the cyst is large or bothersome.
• Surgical treatment: Surgical excision is recommended for patients for non-surgical treatment has failed. The surgical options are as follows:
  • Open excision removes the cyst along with its stalk and wall. Recurrence may still occur in some cases. A splint is usually worn for 2 weeks after surgery, followed by gradual movement.
  • Arthroscopic excision uses small incisions and causes less damage to the soft tissue. A small camera allows enhanced visualisation of the joint (most commonly the scapho-lunate joint) without jeopardising the articular cartilage. However, this technique requires special expertise.

You should see a doctor if:

• The swelling grows in size quickly.
• The swelling causes pain.
• Movement is limited due to the swelling.
• Tingling or numbness is experienced in the fingers or toes.

There is no sure way to prevent ganglion cysts. However, avoiding repetitive stress on the wrists and using supportive equipment during high-impact activities may help reduce the risk.

If you suspect a ganglion cyst, you should consult an orthopaedic surgeon or a hand and wrist specialist. In some cases, a physiotherapist may be involved in recovery after treatment.