Ganglion Cyst
What is it: A ganglion cyst is a cyst that develops over a joint or tendon sheath that fills with synovial fluid.
How does it present: It may present as a painless nodule or cyst on the wrist, hand or finger. Sometimes due to its location or activity, the cyst may become painful. It may increase or decrease in size over time.
Common exam findings: Ganglion cysts are most commonly found over the dorsum of the wrist or along the radial artery region, but they may occur in many places. The cyst is usually clearly demarcated and may or may not be tender. When evaluating a cystic structure in the area of the radial artery, ensure that it is not a pulsatile mass, such as a radial artery aneurysm, by palpating for a pulse. Transillumination can also assist in the differential diagnosis of a ganglion cyst.
Tests and treatment: A diagnosis of a ganglion cyst is usually clinical and no further tests are generally needed. If the cyst is asymptomatic, no treatment is needed. If the ganglion is painful, aspiration of the fluid and possible injection with steroid can be considered. However, there is an approximately 50% recurrence rate. Surgical intervention can be considered if aspiration does not result in resolution and has a lower recurrence rate.