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What does it feel like?

Patients complain of a lump that sometimes changes in size and occasionally disappears when accidentally struck. Sometimes, they can cause a dull aching pain in the wrist. Most commonly, these are located on the back of the wrist, and become particularly obvious when one flexes down the wrist.

 

What is it?

It is a balloon of clear, thick fluid that tends to form around joints and tendons with a neck to the origin of the fluid. The neck usually contains a one-way valve, which means that fluid can enter the ganglion, causing it to grow, but fluid cannot easily exit the ganglion the way it came in.

 

What causes it?

The theory is that a rent or small weakness in a joint capsule or tendon sheath allows fluid to escape into the ganglion. This fluid is unable to return to its origin where it can be absorbed, and therefore continues to leak into the ‘balloon’, thus causing the ganglion to enlarge.

 

What are my treatment options?

First, the ganglion warrants basic imaging, such as an X-Ray and ultrasound, to confirm the diagnosis and to provide any further detail that may aid future management.

Options for treatment depend on the symptoms that the ganglion is causing. If the lump is not distressing in appearance, nor painful, it is perfectly acceptable to observe it over time without any intervention.

Aspiration of a ganglion is an option, but it should be noted that these frequently recur. The reason for this is that the neck of the ganglion still remains, and fluid is still able to leak out to form another ganglion over time. Surgical excision of a ganglion has a significantly  better success rate, as the neck of the ganglion and its origin are removed.