Ganglions/Mucous Cyst

What is it?

A ganglion or mucous cyst is a swelling, containing a jelly-like material, found around the wrist or overlying the end joint of a finger or the thumb. The cyst may fluctuate in size and occasionally burst spontaneously before reforming.

Who gets it and what causes it?

This condition usually affects people between 45-70 years old and is usually seen in association with osteoarthritis of a joint. Sometimes it is caused by trauma. The cyst communicates with the joint.

What are the signs and symptoms?

The cyst may be painful or unsightly.

What tests will I need?

A consultation, involving a medical history and clinical examination, is usually sufficient to make a diagnosis but an X-ray may be taken of your hand or wrist to identify any osteoarthritis.

What is the treatment?

No treatment is usually necessary as these cysts are harmless, and they often resolve spontaneously with time.

Unfortunately, surgical treatment has a relatively high recurrence rate. It can be indicated in some cases however. Multiple needle fenestration of the cyst is an alternative with fewer complications that can be performed in the outpatient clinic.

What does the surgical treatment involve?

Needle fenestration in the clinic aims to deflate the cyst and with the inflammation produced, scars the cyst down so it does not reform, or if it does, it is smaller and less problematic.

Surgery removes the cyst and its connection to the joint. Also, if there is any osteoarthritis of the associated joint attempts will be made to reduce this as that will lower the chances of the cyst recurring.

Mr Miller performs needle fenestration and ganglion/mucous cyst surgery at Claremont Private Hospital. If surgery is performed this usually lasts around 30 minutes and is a day case procedure requiring only local anaesthetic. The surgical scar is usually very small.

What happens after the surgery?

Taking simple painkillers regularly for the first few days after the operation will help to relieve any post-operative pain. Stitches are of the resorbable (dissolving) kind so will not need removal. A wound check will be organised either at your GP surgery or at the Claremont Hospital 5-7 days after your operation and a follow-up appointment to see Mr Miller 1-2 weeks after that.

When I can return to normal activity? 

If you are a manual worker it is advised to stay off work for around 3-6 weeks. If you work in an office a period of 1-2 weeks off work should be sufficient.

You are advised not to drive for at least 1 week after surgery.

What are the complications of surgery?

There may be persistent pain and stiffness post-operatively especially if there is underlying osteoarthritis of the nearby joint. The main risk is that of infection, likely around 2% risk. Because the cyst is close to the nearby joint, this occasionally can involve the joint (<1% risk).  A small percentage of patients (1% or less) will develop a severe reaction after hand surgery (called CRPS), with long-standing pain and loss of use in the hand which is something that is difficult to treat. If you are concerned about any of these risks, or have any further queries, please speak to Mr Miller.