Ganglion Cysts
Quality care provided by an Orthopaedic surgeon
Ganglion cysts arise in the wrist and hand and are lumps filled with fluid. These cysts develop in joints and spread to surrounding tissues, and place pressure on nearby tendon sheaths, ligaments, vessels and nerves. These cysts are generally located near the wrist's back but can also affect finger bases, elbows, feet, ankles and the knee area (Baker's cyst).
Ganglion cysts may constitute the size of a pea or have a diameter of a few centimetres. They may also change in size, appear quickly and disappear. Most of these cysts are harmless and non-cancerous, and treatment is not often required.
However, Ganglion cysts may put pressure on a tendon, vessel or nerve, become painful, or interfere with wrist and hand movement abilities. If this occurs, various treatment measures are available to rectify this condition.
Causes and Risk Factors
The direct cause of Ganglion cyst development is largely unknown. Many medical professionals theorise that Ganglion cysts develop due to overuse or trauma, and may arise due to small tendon membrane tears resulting in lubricating fluid leaking.
There are, however, specific factors that seem to increase the likelihood of Ganglion cyst development, including:
- Gender and age - These cysts are predominant in women between 15 and 40.
- Joint or tendon injury - The risk of Ganglion cyst development seems to increase after previous tendon or joint injuries.
- Osteoarthritis - Arthritic finger joints increase the risk of developing these cysts.
- Stress - Ganglion cysts are common in gymnasts whose wrists and hands are frequently under stress.
Symptoms of Ganglion Cysts
Many individuals with Ganglion cysts notice swelling or soft lumps that progressively disappear and reappear or change size. Ganglion cysts may not produce symptoms, but if they become larger and place pressure on nerves surrounding the joint, pain may arise.
Pain may increase when nearby joints engage in movement, and muscle weakness may occur in the affected wrist or hand tendons. The contents of the cyst (i.e., water or another liquid) can be identified through evaluating translucency by shining a light on the affected area.
Diagnosis of Ganglion Cysts
If you believe a Ganglion cyst is developing in your hand, you should have this examined by a medical professional to ensure you are not experiencing symptoms for another hand or wrist condition. Dr Oscar Brumby-Rendell is an orthopaedic surgeon who can assess your hand to establish if you have a Ganglion cyst or another condition.
At your consultation, Dr Brumby-Rendell will discuss your medical history and symptoms and conduct a physical examination to make a diagnosis. Here, he will gently place pressure on your hand to discover tenderness or pain.
This physical examination is generally the only assessment required for diagnosis. However, in some complex cases, other assessments may be needed to reach an evidence-based diagnosis, including:
- Removing cyst fluid using a syringe
- An ultrasound, which evaluates cyst firmness
- An MRI, which examines cysts invisible to the eye and identifies if surrounding vessels, nerves or tendons are affected by the cyst
- X-ray tests may also be implemented to ensure symptoms are not caused by other illnesses or diseases, including arthritis.
Treatments
Non-Surgical Treatments
These cysts are non-cancerous and generally disappear with time. Therefore, treatment normally consists of monitoring to ensure abnormal changes do not ensue. Previously, the 'treatment' prescribed for Ganglion cysts was banging heavy items onto them. This practice is not recommended as further injury could result.
Dr Brumby-Rendell may simply advise observation if the Ganglion cyst does not interfere with daily life or cause pain. Monitoring ensures that any abnormal changes are identified quickly for proactive treatment.
Immobilisation through a splint or wrist brace may be advised, as movement can result in the growth and largening of cysts. Dr Brumby-Rendell may recommend physiotherapy to promote wrist strengthening if the cyst begins to decrease.
Aspiration is another conservative measure, which consists of draining the fluid by puncturing the Ganglion cyst after numbing the surrounding area. The lesion may also be injected with a steroid to promote resorption and decrease the cyst's size; however, the cyst generally grows back because its 'root' remains.
Surgery may be advised if a patient's symptoms are not resolved by the conservative measures explained above.
Surgical Treatments
The cyst and associated tendon sheath or joint capsule are removed via surgery. If a Ganglion cyst continues to cause pain after conservative treatment methods and grows back after aspiration, surgery may be recommended by Dr Brumby-Rendell. This surgical procedure is conducted under general anaesthetic in an operating theatre and is called excision. When possible, Dr Brumby-Rendell implements minimally invasive approaches to promote optimal healing. Generally, patients will not be required to stay at the hospital overnight.
Post-Surgical Recovery
Post-surgery, patients may experience discomfort and tenderness and be required to wear a splint for approximately 2 weeks (this depends on the specific details of the joint capsular repair). Recovery takes between 2 and 8 weeks, depending on the cyst's size and location.
Your recovery will be monitored by Dr Brumby-Rendell, who will provide recommendations to increase your wrist or hand function. To strengthen and heal your wrist or hand, specially designed exercises may be prescribed.
How Dr Oscar Brumby-Rendell can help
Dr Oscar Brumby-Rendell provides consultation and treatment in Adelaide for various hand and wrist conditions.
Dr Oscar Brumby-Rendell has extensive upper limb experience in areas of diagnosis, treatment and surgery. In your consultation, Dr Oscar Brumby-Rendell will develop a treatment plan with you to ensure the best possible results for your hand or wrist condition.
Click for more information regarding shoulder, hand, wrist, and elbow conditions which Dr Oscar Brumby-Rendell has experience in treating.