Understanding Ganglion Cyst: Symptoms, Causes, Diagnosis, and Treatment Options

Ganglion Cyst Symptoms

Ganglion cysts are usually noticeable due to a visible lump or swelling near a tendon or joint. Common ganglion cyst symptoms include:

• Visible appearance of a lump or swelling along the tendons or joints of the wrists or hands.
• Joint pain.
• The cyst is typically firm, rounded, smooth, and occasionally painful.
• Sometimes, the cyst can impinge on the nerve, resulting in sensory and nerve impairment.

Ganglion Cyst Diagnosis

• Physical Examination:Your doctor would first question your general health and symptoms before conducting a thorough physical examination. Diagnosis is made based on your reported symptoms, physical examination, and investigations.
• Transillumination Test: In patients with a palpable swelling, the transillumination test offers a simple in-office way to differentiate ganglion cysts from solid tumours. Ganglion cysts transilluminate while solid tumours do not.
• Magnetic Resonance Imaging (MRI): To differentiate most ganglion cysts from other types of masses in patients with unexplained wrist pain.

Ganglion Cyst Treatment Options

Although ganglion cysts are non-cancerous, they may lead to pain, loss of function, and weakness, requiring treatment. Generally, treatment is only advised if the cyst causes pain or limits the range of motion in a joint. Ganglion cysts treatment options include:

1. 1. Observation 

   For asymptomatic patients (those without noticeable pain or functional issues), observation is often the first step in treatment. Over 50% of ganglion cysts may resolve spontaneously without the need for medical intervention.

   • Reassurance: Patients should be reassured that the cyst might shrink, or disappear on its own over time.
   • Brace Usage: A brace can be used temporarily to support the joint, but it should be worn cautiously. Long-term immobilisation may lead to muscle atrophy, so it’s essential to avoid prolonged use.

2. 2. Cyst aspiration

   Cyst aspiration involves using a needle to withdraw the fluid from the ganglion cyst. While this method can provide relief by reducing the size of the cyst, it has a high recurrence rate.

   • Effectiveness: Aspiration can provide temporary relief, but more than 50% of ganglion cysts treated this way will recur within a year.
   • Alternative Options: If aspiration fails or the cyst returns, other treatment methods may be considered.

3. 3. Surgery

   Surgery is generally considered when symptoms persist or the cyst recurs despite other treatments. Surgical options include both open surgery and arthroscopic excision of the cyst and its stalk.

   • Open or Arthroscopic Excision:This involves the removal of the cyst along with its stalk, which is the structure that connects the cyst to the joint or tendon sheath.
   • Effectiveness: Surgical removal is usually effective, but the cyst can recur if the entire cyst and stalk are not completely excised. Careful surgical technique is crucial to reduce the likelihood of recurrence.