Ganglion Cysts

• Types of cysts

  • Ganglion cysts
• Ganglion cysts

  Sacs of synovial fluid that originate from the tendon sheaths or joints
• Ganglion cysts commonly occur in the wrist and fingers but can occur anywhere there is a joint or tendon sheath
• Ganglion cysts occur when the synovial membrane of the tendon sheath or joint herniates, forming a pouch, and synovial fluid flows into the pouch, forming a cyst
• Ganglion cysts can appear rapidly (over days) or gradually
• Patients present with a visible and palpable lump, usually not painful
• Rarely, ganglion cysts may compress nerves, leading to sensory or motor symptoms
• On examination, ganglion cysts

  • Range in size from 0.5 to 5cm or more (most are 2cm or less)
  • Firm and non-tender on palpation
  • Well-circumscribed
  • Transilluminates (shining a torch into the cyst causes the whole lump to light up)
• Needle aspiration

  Draining the cyst by aspirating the fluid with a needle
• Surgical excision


  Open or endoscopic removal of the cyst, usually under local anaesthetic
• Needle aspiration has a high rate of recurrence (50% or more)
• Surgical excision involves removing the entire cyst and the affected part of the joint capsule or tendon sheath. Therefore, the recurrence rate is low. However, there is a risk of complications, such as infection and scarring