A ganglion, or cyst, is a collection of fluid that builds up on either the back or the front of the wrist. Usually it is an ‘outpouching’ of the wrist capsule, forming a bump or lump on the wrist.
There may be a history of trauma, such as a fall, or a direct blow. Often there is no known cause or history of injury.
There is usually a lump, or mass on one side of the wrist. It may be painful or painless, and may change size or come and go.
The swelling, or lump is generally diagnostic. There may be tenderness, or loss of wrist motion.
The mass must be differentiated from other causes of swelling, such as a benign tumor, ruptured tendon, or other condition. X-rays are of limited value. An aspiration of the contents of the cyst is usually diagnostic.
A trial of an aspiration of the cyst contents, along with a corticosteroid injection and a compressive dressing for a short period of time may resolve the cyst in up to one half of cases. Repeated aspirations are generally not very successful.
Excision of the cyst. This may be done with an open surgical procedure, or recently, we have begun excising the cysts arthroscopically.
Arthroscopic cyst excision seems to provide superior results, with faster healing, and less stiffness and scarring. There is a low, but not insignificant recurrence rate for open cyst excision. We do not yet know what the recurrence rate will be for arthroscopic cyst excision.