Ganglions

Ganglions are cysts that are most commonly found on the back of the wrist. In this site, they are called dorsal wrist ganglions. They are round, smooth and often feel as hard as bone.

Ganglions can also be found on the front of the wrist (volar wrist ganglions), at the base of the fingers in the palm (flexor sheath ganglions), or around the base of the fingernails (mucoid cysts). Very occasionally, ganglions will develop internally, within a bone or a nerve.

Ganglions are benign and do not always need to be removed. It is not known why they develop, although there is thought to be a link with minor injury or arthritis of the underlying joints. Ganglions rarely cause pain. Sometimes, the condition which causes the ganglion (for example, arthritis) can cause pain around the site of the lump, and this may make you think that it is the ganglion which is painful.

Ganglions can be left alone, aspirated or excised. Aspiration of the jelly-like contents will result in an immediate deflation of the ganglion, but around 80% will fill up again - often within days. Aspiration is a useful technique to confirm the diagnosis if this is uncertain. Surgical excision involves a scar, which is permanent and may be tender, and a deeper dissection to try and find the connection of the ganglion to the underlying joint. Removing a ganglion usually requires a general or regional anaesthetic (where the whole arm is frozen). Finger ganglions can be removed using a local anaesthetic, however.

Even after successful surgery, around 20% of ganglions will return.

Further information on ganglion cysts is available at Ganglion cysts and at Ganglion info