“I have a ganglion cyst in my left wrist”
The ganglion cyst in my left wrist seems to be getting larger. Can it be drained or removed? My doctor didn't mention it but it seems to be getting in the way of my daily life.
13 Answers
Both are viable treatment options.
If the cyst is on palm side, we do not drain -- you have to have it surgically removed. If the cyst is on top of the hand, you can try draining it.
Depending on where the cyst is it may or may not be amenable to drainage. Drainage has a very high, almost guaranteed rate of recurrence associates with it. Surgery is usually definitive but even that can have a 15-20% recurrence rate.
Yes, ganglion cysts are routinely removed surgically. Depending on location, this may be done either in a procedure room or in the operating room. Draining these cysts typically isn't done due to the very high rate of recurrence. Please check with your board-certified hand surgeon.
Ganglion cysts are very common and can cause discomfort. One treatment option is to aspirate and/or inject a steroid with two weeks of protective bracing. If the ganglion cyst does not resolve with this treatment, an MRI can be helpful to determine the underlying cause (ligament tear, etc.).
It can be drained, but they do tend to come back. If it bothers you, it's probably best to get it removed. Unfortunately, once you have a weakening of the joint capsule, you will always have the chance of recurrence, but if symptomatic, I believe that surgery is the best option with low risk.
Is the ganglion on the back of your wrist or the palm side? Ganglion cysts are quite easily and safely excised surgically. Those on the back of the wrist can often be drained, but this does not always get it to resolve. Even with surgical excision, there is always a slight risk of recurrence.
Wrist ganglion cysts are quite common. If it does not bother you, then I do not recommend any treatment. In your particular case, where you are having symptoms, you can initially try to have it drained (aspirated). However, in the majority of cases, the cyst recurs after aspiration. If recurs after aspiration, and your symptoms warrant, then you can consider surgical removal.
Ganglion cysts of the wrist are not uncommon. Approximately 80% occur on the dorsum or the back of the wrist whereas 20% occur on the volar or palmar side of the wrist. Ganglions on the dorsum of the wrist can be drained but those on the volar side should not be due to their proximity to the radial artery. Ganglions that have been drained have a high recurrence rate. The definitive treatment of a wrist ganglion is surgery.
Ganglion cysts at the wrist are more commonly surgically removed. Trying to drain ganglion cysts are not as successful because they are generally solid and not fluid enough to drain. If the cyst is affecting daily duties and growing in size, I would recommend that you see a hand specialist for an opinion.
Yes. It can be drained or removed. Draining with a needle is easier but will have more frequent risk of recurrence.
Often, a ganglion can be aspirated (drained). But sometimes, the fluid is too thick to draw through a needle. They frequently come back after aspiration. Surgery is most often a cure as recurrence is far less frequent. This should be performed by an orthopaedic surgeon or plastic surgeon with specific skills in hand and wrist surgery.
It is important to make sure that indeed your mass is a ganglion (benign fluid filled mass). Typically your hand surgeon may check an X-ray and then try to transilluminate the mass with a penlight and/or aspirate with a needle to confirm its truly a ganglion. Most ganglions do not cause significant pain or dysfunction and rarely need to be removed surgically. If your mass is bothering you it should be evaluated. Assuming it is a ganglion, sometimes simple wrist splinting and / or aspiration can help your symptoms and many will resolve over time. Please go to ASSH.org (American Society for Surgery of the Hand) and read about ganglion cysts under common conditions , you can also find a fellowship trained hand surgeon near you for an evaluation.
