Ganglion Cyst
What is it: A ganglion is a cystic structure that develops over a joint or tendon.
How does it present: The patient usually reports the development of a painful or non-painful swelling. They may fluctuate in size. They are common in the hand, but can also be noted on the feet.
Common exam findings: On exam a swelling or cystic structure may be identified, and this can be tender or non-tender. Particularly in the region of the wrist, a ganglion should be differentiated from a vessel aneurysm. A vascular aneurism may be pulsatile or have a bruit.
Tests and treatment: If the diagnosis of ganglion cyst is certain, no further testing is needed. If the diagnosis is unsure, an attempt at aspiration may be done. Aspiration of the typical thick clear fluid is fairly diagnostic. If further evaluation is needed, MRI could be considered. If the ganglion is not painful, no treatment may be needed. In cases where treatment is desired, aspiration of cyst contents, followed by injection of steroid can be used. In some cases surgical excision can be done. In both cases there is a chance of recurrence.