Ganglion Cyst of the Wrist
Andreas Leonidou
Orthopaedic Surgeon
- Symptoms
- Conservative Treatment
- Surgical Treatment
- Costs
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What is a Ganglion Cyst of the Wrist?
A ganglion cyst of the wrist or radiocarpal ganglion cyst is a benign cyst that contains a sticky fluid and develops beneath the skin. The fluid is usually thick and clear, with a gel-like consistency. A ganglion cyst usually arises from the wrist joint or from the sheath of a tendon.
What are the main causes?
We do not know exactly what causes a ganglion cyst. The most widely accepted theory is that injury or degenerative changes (osteoarthritis) of the tissues result in fluid escaping from the joint or tendon sheath, leading to the formation of the ganglion cyst. Ganglion cysts usually occur in women and in people who perform manual work. They also often occur in patients who perform frequent repetitive low-intensity movements, such as daily keyboard use.
Where Does a Ganglion Cyst of the Wrist Occur?
A ganglion cyst can occur in various areas around the wrist. The most common locations are:
Dorsal wrist ganglion cyst: It occurs on the back of the wrist and is the most common type of ganglion cyst.
Volar wrist ganglion cyst: It is the second most common type of ganglion cyst and often comes into contact with the radial artery.
Intraosseous ganglion cyst: This type of ganglion cyst occurs within the bones of the wrist.
Dorsal surface of the fingers: The ganglion cyst occurs on the dorsal surface of the distal joint of the fingers and is associated with the presence of osteoarthritis.
Flexor tendon ganglion cyst: This ganglion cyst arises from the tendon sheath – usually the flexor tendons – and occurs at the base of the fingers and in the palm.
In addition to ganglion cysts of the hand and wrist, ganglion cysts occasionally occur in the lower limbs – most commonly on the dorsum of the foot.
What are the symptoms?
The ganglion cyst is visible and may constitute a cosmetic concern. It also often fluctuates in size. Most of the time, the ganglion cyst is asymptomatic – painless. In some cases, however, it may cause pain and weakness during movement of the wrist and fingers due to pressure on the joint or tendons. More rarely, if the ganglion cyst compresses a nerve, it can cause numbness and weakness in the fingers. Occasionally, when located on the palmar surface, it causes pain with pressure and difficulty when performing office work.
How is the diagnosis made?
A patient with a wrist ganglion cyst requires assessment by a specialized Orthopaedic Surgeon. Mr Leonidou will take a detailed medical history and examine you. The doctor will perform an ultrasound examination to confirm the diagnosis and will discuss the recommended treatment options with you. Occasionally, further tests such as plain X-rays or an MRI scan may be required to investigate possible underlying osteoarthritis and to determine whether the ganglion cyst is compressing underlying structures.
Conservative Treatment
The initial management of a ganglion cyst is conservative and includes:
• Observation and lifestyle modification with reduction of manual work
• Appropriate equipment for office work (ergonomic keyboard and mouse)
• Temporary immobilization of the wrist with a special brace
• Aspiration of the ganglion cyst under ultrasound guidance, with or without cortisone injection.
Recurrence rates (reappearance of the ganglion cyst) with conservative treatment are quite high and may reach up to 50%. It is worth noting that in some cases, the ganglion cyst may resolve on its own without any treatment.
Surgical Treatment – Indications
The ganglion cyst should be removed when it causes severe pain and subsequent dysfunction of the wrist and/or fingers. Removal is also required when, due to its size, it causes symptoms from compression of nerves or tendons. Finally, patients often choose to have the ganglion cyst removed because of the cosmetic problem it causes.
How is a Ganglion Cyst of the Wrist Removed?
Ganglion cyst removal is usually performed under local anesthesia. The patient does not require hospitalization and returns home within a few hours. The incision for ganglion cyst removal is minimally invasive – small – and there are usually no external sutures (plastic closure). Postoperatively, a dressing is kept in place for 48 hours and then gradual – full return to daily activities and work is encouraged.
It is important that ganglion cyst removal is performed by a specialized orthopaedic surgeon using special magnifying loupes, in order to avoid injury to underlying structures and to ensure complete excision of the cyst. Complete removal of the ganglion cyst minimizes the possibility of recurrence.
Can it recur after surgery?
If the ganglion cyst is removed by a specialized orthopaedic surgeon using the appropriate equipment, then the likelihood of recurrence is minimal.
What is the cost of removal? How much does the procedure cost?
The cost is quite affordable. For more information regarding the procedure and the cost of surgery, you can contact us. If you have a ganglion cyst that concerns you, visit the specialized orthopaedic surgeon Mr Andreas Leonidou for an accurate diagnosis and personalized treatment. The doctor has 14 years of continuous professional experience in the United Kingdom and specialization in hand conditions.
Book your appointment for immediate diagnosis, specialized care and targeted treatment in just one visit.