What is a Ganglion Cyst?

Pathophysiology of Ganglion Cysts

Ganglion cysts are benign, mucin-filled pseudocysts arising from periarticular connective tissue, capsule, or tendon sheaths. A micro-valve mechanism allows synovial fluid to exit the joint capsule into the cyst wall without flowing backward, creating a visible palpable lump.

Clinical Presentation

Most common on the dorsal wrist, these masses fluctuate in size depending on activity levels. While frequently painless, compression of nearby sensory nerve branches can elicit aching pain, weakness, and restricted wrist extension.

Diagnostic and Treatment Modalities

• Clinical transillumination and diagnostic high-frequency ultrasound confirmation
• Conservative observation and temporary wrist splinting for painless cysts
• Needle aspiration and corticosteroid instillation
• Complete surgical excision (open or arthroscopic) removing the pedicle to minimize recurrence

Frequently Asked Questions

Is it safe to crush a ganglion cyst with a heavy object?

Crushing cysts with hard objects is strictly contraindicated as it risks fractures, tendon laceration, and joint infection.

What is the recurrence rate after needle aspiration?

Aspiration carries an approximate 50% recurrence rate because the stalk remains intact, whereas complete surgical resection reduces recurrence to below 10%.