Ganglion Cysts

Ganglion cysts, also called Bible cysts are noncancerous fluid-filled masses that appear on the tendons or joints of your wrists or hands and sometimes on the ankles and feet.

They are usually round or oval in shape. Small ganglion cysts can be as small as a pea whereas larger cysts can have diameter of an inch (2.5 centimeters). Ganglion cysts can press the neighboring nerve and cause pain or sometimes they can affect joint movement.

If your ganglion cyst causes you some discomfort, your doctor may drain the fluid in cyst by using needle or may perform surgery to remove the cyst. Usually, no treatment is required as the cyst disappears on its own. 

The symptoms of Ganglion cysts include:

• Site: Tendons or joints of your wrists or hands are the most common sites of occurrence. Ganglion cysts on the ankles and feet are not as common as those in wrists or hands. These cysts may also develop near other joints.
• Form and dimension: They are usually round or oval in shape. Some cysts are so small that they are rarely noticed while some can be an inch (2.5 centimeter) in diameter. The size of a cyst can increase or decrease. The size increases when joints containing the cysts are used frequently.
• Pain: Ganglion cysts generally cause no pain. But pain, tingling, numbness or muscle weakness is experienced if the cysts happen to compress a nerve.

When to see a doctor?

Make an appointment with your doctor if you notice a bulge or feel pain in your wrist, hand, ankle or foot.

The exact cause of ganglion cyst is unknown. There are various theories that have tried to explain the basic mechanism and cause of ganglionic cysts.

One of the theories suggests that these fluid-filled masses occur due to abnormalities in the joint capsule or tendon covering.  

Diagnosis of ganglion cysts include:

• Physical examination: Your doctor starts the diagnosis by physical examination. S/he may press the cyst to see if it’s tender or it causes distress. The doctor may check whether a light shines through the cyst to find out if the cyst is a solid mass or contains fluid.
• Imaging tests: Such as X-rays, ultrasound or magnetic resonance imaging (MRI), may be performed to see if you have any other medical conditions, such as arthritis or a tumor. MRIs and ultrasounds can detect hidden (occult) cysts.

Your doctor may draw (aspirate) fluid from the cyst with a needle to confirm the diagnosis. The fluid aspirated from the cyst is usually thick and translucent.

Usually no treatment is opted if your ganglion cysts are painless. Following treatment approaches may be suggested for painful cyst or cyst that affects joint movement:

Using orthotics

Splints or braces are used to prevent the growth of cyst since the cyst increases with increase in activity. The compressed nerve may be released after the cyst shrinks and hence provide relief from pain. Using brace or splint for a long period of time can weaken the neighboring muscles.

Drawing out the fluid (Aspiration)

Your doctor draws out the fluid from the cyst with a needle. However, the cyst can come back again.

Surgery

Surgery is performed when other options fail to resolve your condition. The cyst and the stalk which attaches cyst to the joint or tendon are surgically removed.

The surgery may damage the surrounding

• nerves,
• blood vessels
• tendons.

The cyst may return even after surgery.

There are several risks and complications associated with ganglion cysts, which include:

• Age and sex: These cysts are more common in women aged between 20 and 40.
• Osteoarthritis: Having an osteoarthritis (degenerative joint disease) may increase your risk of developing cysts near such your affected joints.
• Joint or tendon injury: Injured joints or tendons are at risk of developing ganglion cysts.