What is it?
They are benign lumps of different size and consistence, which commonly occur on the back of the hand, on the palm side of the wrist, the base of the thumb and at the top of the end joints of the fingers. They are little balloons filled with gelatinous contents the stalk of which starts in the joints. There are also more rare forms of the cysts occurring in the dorsal carpal ligaments or in the tendons
Why they happen?
It is difficult to determine explicitly the reasons for formation of the cysts. Its formation may be initiated by e.g. hitting a table with a hand, or a jerk, inflammation within the tendons or any other undetermined factor.
Symptoms. Examination and diagnosing of the disease
Large cysts are easy to diagnose. They are noticeable on the skin. They may be soft or hard, mobile or immobile, mono-locular or multi-locular. They may shrink in the morning and grow at the end of the day. They may be painless or painful, restrict mobility or not. A physician may order additional USG, x-ray, CT, RMI examination in order to obtain accurate location and extent of the change. There are cysts that are invisible outside, but causing painful conditions. Their placement is possible only after performing the abovementioned tests.
A simple diagnostic test is the “transparency” test:
Directing a stream of light from a torch at a cyst makes it “glow”.
Not all the cysts require surgical removal. Many cysts disappear without any treatment at all which can be often observed in children. Aspiration of a cyst can be performed – preferably under the control of the USG – in order to draw the liquid material out and inject medicine into the cyst and then splinting the wrist to keep it from moving.
We do not recommend smashing the cyst (by hitting it with a book, etc.). because it may result in formation of a multi-locular cyst, which will require a more extensive surgical operation for the cysts to be removed.
Surgical operation involved removal of a cyst together with its stock from the place of its formation.
The surgery should be as non-invasive for the patient as possible,
After the surgery, the wrist is splintered (orthesis, plaster splint) in order to let the place of cyst formation and the wound heal. After removal of the splints, we start a short rehabilitation in order to increase the efficiency of the hand.
Ganglion cysts may come back after any of these treatments, however.