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Ganglion Cyst

Exams and Tests

A physical exam is often all that is needed to diagnose a ganglion cyst.

  • Your doctor may get further confirmation by using a syringe to draw out some of the fluid in the cyst (needle aspiration) or by using ultrasound. An ultrasound picture is made as sound waves bounce off of different tissues. It can determine whether the bump is fluid-filled (cystic) or if it is solid. Ultrasound can also detect whether there is an artery or blood vessel causing the lump.
  • Your doctor may send you to a hand surgeon if the bump is large or solid or involves a blood vessel (artery).
  • Magnetic resonance imaging (MRI) is used to see the wrist and is very useful for ganglions. One drawback to this diagnostic method is the cost of the procedure.

 

Ganglion Cyst Treatment: Self-Care at Home

In the past, home care has included topical plaster, heat, and various poultices. It even extended to use of a heavy book to physically smash the cyst. (Sometimes this is called "Bible therapy.") These forms of treatment are no longer suggested, however, because they have not been shown to keep the ganglion cysts from returning and could, in fact, cause further injury.

Medical Treatment

Many cysts can disappear without any treatment at all.

Various treatments have been proposed over the years. Some include no specific treatment other than reducing worry regarding the cyst, using a needle to remove the cyst's contents (aspiration), or surgery.

  • Aspiration usually includes placing a needle into the cyst, drawing the liquid material out, injecting a steroid compound (anti-inflammatory), and then splinting the wrist to keep it from moving.
  • If you have the fluid drawn out of ganglia on the wrist 3 separate times, your possibility of being cured is between 30% and 50%. The rate of success is higher with ganglion cysts on the hand's flexor tendon sheath.
  • If you compare aspiration/injection and surgical removal, in general, cysts return less often after surgery.

Surgery

Surgical removal of the cyst is needed when the mass is painful, interferes with function (especially when your dominant hand is involved), or causes numbness or tingling of the hand or fingers.

Next Steps Follow-up

After you have been diagnosed with a ganglion cyst and have chosen to have treatment, follow-up will be different based on what you have chosen to do.

  • After simple aspiration, your doctor may ask you to start moving the joint soon after the procedure.
  • Most likely after surgery, your joint will be splinted for up to 7 to 10 days. A splint is a hard wrap that will keep you from moving your joint.
  • Recent studies show that splinting for a long period of time doesn't really help, and use of the joint soon after treatment is being encouraged.
  • Your doctor may ask you to return for a check-up after your surgery and will decide if physical or occupational therapy is needed. Follow-up care will be based on your personal needs.

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