Ganglion Cysts

The wrist is a small and complex body part made up of bones, ligaments, nerves, tendons, and muscles.

Bones Of The Wrist

The long bones of the forearm (the radius and the ulna) connect to the carpal bones to form the wrist. There are a total of eight carpal bones in the wrist which are arranged in two rows: proximal (near to) and distal (further away). The scaphoid bone crosses both rows as it is the largest of the eight carpal bones.

Ligaments Of The Wrist

Each bone in the wrist is joined to the one next to it by one or more ligaments. The two largest ligaments of the wrist are the medial (MCL) and lateral (LCL) collateral ligaments. The MCL passes from the distal end of the ulnar and crosses the wrist to attach to the proximal row of the carpal bones. The LCL passes from the end of the radius, across the joint to the scaphoid which makes up the majority of the distal row.

Nerves Of The Wrist

The radial nerve, median nerve, and ulnar nerve all pass from the forearm, across the wrist, and into the hand. The radial nerve provides feeling to the back of the hand from the thumb to the middle finger. The median nerve passes through the carpal tunnel and splits into four branches which each travel to the thumb and next three fingers, providing the sensation of touch. The ulnar nerve supplies the small finger and the outer half of the ring finger with the sensation of touch.

Ganglion Cysts are noncancerous, benign lumps of fluid that commonly accumulate along the tendons or joints of the wrist or hand. Ganglion cysts also commonly occur in the ankles and feet. These cysts are normally round, circular, or oval in shape and filled with fluid. Ganglion cysts can often be painful if located near a nerve, and their location can often restrict joint movement. Small ganglion cysts can be kernel sized, while larger ones can reach about an inch in diameter.

It is currently unknown what causes a ganglion cyst to develop. A ganglion cyst grows out of a joint or the lining of a tendon and resembles a very small water balloon on a stalk. These cysts seem to occur when the tissue that surrounds a joint or a tendon bulges out of place.

There are, however, risk factors associated with the development of ganglion cysts. These risks include:

• Sex and Age – ganglion cysts most commonly occur in women ages 20-40
• Osteoarthritis
• Joint or Tendon injury

The symptoms of ganglion cysts are best characterized by the lumps that present themselves. These lumps are categorized by:

Location

Ganglion cysts most commonly develop along the tendons or joints of the wrists, hands, ankles, and feet.

Shape And Size

Ganglion cysts are circular or oval in shape and usually measure less than an inch in diameter. Some can be so small that they can’t be felt.

Pain Level

If a cyst presses on a nerve it can cause pain, tingling, numbness and even muscle weakness.

During the exam, the physician will test the lump for any pain and tenderness. The physician will also shine a light on the cyst to determine whether it is a solid mass or if it is in fact filled with fluid. Imaging tests such as XRays, MRIs, and ultrasounds may be recommended to rule out the possibility of a tumor. These imaging tests can also locate hidden cysts. On some occasions, the doctor may draw out some of the liquid of the cyst using a needle to determine if it truly is a cyst. Fluid from a cyst will often be translucent.