INTRODUCTION​

• Ganglion cysts are benign masses most commonly encountered in the wrist, but which may occur in any joint

• They can affect any age group

• The are more common in gymnasts likely due to repetitive use of the wrist

• 70% of ganglion cysts are found in the back or dorsal aspect of the wrist & communicate with the joint via a pedicle or stalk

• Ganglion cysts are benign, non-cancerous, and generally harmless

• They can appear, disappear, and change in size over time

• People would call these “Bible cysts” as they would use a hard book to try to rupture the cyst 

CAUSES

• A history of trauma is present in at least 10% of wrist ganglion cyst cases 

• In the majority of causes, the cause is unknown

SIGNS AND SYMPTOMS

• Wrist ganglion cysts are usually 1–2 cm soft and compressible masses that are mobile

• There is no warmth or redness or associated skin changes

• Aching is common but pain and tenderness are less common

• Wrists on the front or volar aspect of the wrist may cause irritation of the ulnar or median nerve leading to numbness and/or tingling

TREATMENT​​

• Observation is the most common treatment in the majority of patients if it doesn't hurt or interfere with activities of daily living or quality of life

• Wrist bracing and immobilization has been shown to be helpful

• If the cyst becomes associated with pain, interference with activities, and an increase in size, intervention may be appropriate

• Aspiration can be considered by removing the cyst with a needle. Studies show that repeat aspirations demonstrate a success rate of 30–50%

• Surgery is reserved for cases that are refractory to conservative treatment. Surgery involves the excision of the entire ganglion complex, including cyst, pedicle, and a cuff of the adjacent joint capsule, with recurrence rates in the 7-10% range for dorsal cysts and slightly higher for volar cysts

        PREVENTION

• The best way to prevent a wrist ganglion cyst is to minimize repetitive wrist motion and exertional activities