Introduction
Wrist ganglions are fluid filled lumps (cysts) which arise in relation to joints / ligaments/tendons in the wrist. They are benign and filled with mucinous (gel-like) fluid.
Ganglions are the most common lumps found in the wrist and hand. They are most commonly found in the back of the wrist (70%) or the front of the wrist (20%). They can also be found in fingers.
Ganglions most commonly occur in the 15-40yr age group. Females are most commonly affected.
Most ganglions are painless and do not require any particular treatment.
Causes
Most ganglions do not have a specific cause
They may occur as a result of mechanical irritation or trauma to the joints/tendons or ligaments.
Signs and symptoms
Diagnosis is based on patient symptoms, examination findings and scans. Most ganglions do not cause symptoms
Pain / Tenderness
Some ganglions may cause pain in the back or front of the wrist.
Lump
Some ganglions may be very small and an obvious lump not visible.
Translucency
Because a ganglion is filled with fluid, light will shine through when your doctor examines it with a torch.
Tests
Ultrasound
Ultrasound will demonstrate size and location of ganglion.
MRI
MRI will show a fluid filled ganglion and will demonstrate evidence of tendon/ligament/joint injury which may be associated with it. It will also demonstrate its relationship to important structures such as blood vessels or nerves.
Non-surgical treatment
Ganglions are benign, most are painless and do not require treatment. Some ganglions may go down in size eventually.
Treatment is required for ganglions that are painful or interfere with activity.
Activity Modification
Avoiding activities which cause pain. This may involve stopping particular sports, changing jobs or changing roles at work.
Wrist Splint / Brace
It stops your wrist from moving and can reduce the pain of the ganglion. Immobilisation can sometimes stop the ganglion from getting bigger as the joint is not irritated.
Needle Aspiration
This involves place a needle in the ganglion and draining fluid from it. Recurrence of the ganglion is however common with this procedure as it doesn't eliminate the root of the ganglion. The risks of needle aspiration also include infection and damage to blood vessels.