Ganglion cyst

Background

• Cystic collection of synovial fluid within a joint or tendon sheath
• ~33% resolve spontaneously

Clinical Features

Ganglion cyst on posterior wrist.

Ganglion cyst on anterior wrist.

• May appear quickly, recede, change in size
• Most are not painful
• Interference with function, poor cosmetics, and pain may require routine referral to hand surgeon

Differential Diagnosis

Hand and finger injuries

• Distal finger
  • Finger amputation
  • Fingertip laceration
  • Nail avulsion
  • Nailbed laceration
  • Subungual hematoma
• Other finger/thumb
  • Boutonniere deformity
  • Mallet finger
    • Swan neck deformity
  • Jammed finger
  • Jersey finger
  • Trigger finger
  • Ring avulsion injury
  • De Quervain tenosynovitis
  • Infiltrative tenosynovitis
  • Metacarpophalangeal ulnar ligament rupture (Gamekeeper's thumb)
• Hand
  • Dupuytren contracture
• Wrist
  • Drummer's wrist
  • Ganglion cyst
  • Lunotriquetral ligament instability
  • Scaphoid fracture
  • Extensor digitorum tenosynovitis
  • Compressive neuropathy ("bracelet syndrome")
  • Intersection syndrome
  • Snapping Extensor Carpi Ulnaris
  • Vaughn Jackson syndrome
• General
  • Hand and finger dislocations
  • Hand and finger fractures
  • Hand and finger infections
  • Gout and pseudogout
  • Hand and finger tendon injuries
  • High-pressure injection injury
  • Osteoarthritis
  • Rheumatoid arthritis
  • Ring removal

Evaluation

• Generally clinical diagnosis
  • Ultrasound may be useful in equivocal cases (shows a fluid filled structure)

Management

• NSAIDs
• Refer to hand surgeon for persistent or recurrent pain or cosmetic deformity

Disposition

• Discharge

See Also

• Hand and finger diagnoses