Ganglion Cysts of the Wrist

Courtesy: Prof Nabil Ebraheim, University of TOledo, Ohio, USA

Ganglion cyst of the wrist

• Fluid filled cysts that are benign and will not spread.
• It may vary in size from time to time and may grow in size but does not cause harm to the
  patient .
• When the cysts pressurise an artery, nerve or tendon it causes problem.
• The cysts transilluminates , therefore an MRI is not required.
• The cysts can be dorsal or volar .
• Dorsal type is the most common.
• It arises from the scapholunate articulation.
• The volar ganglion may compress the radial artery and this might compromise the circulation of
  hand.
• It arises from radiocarpal joint, ie, the wrist.

Clinical findings:

• A mass that is well defined , localized, smooth and not attached to skin.
• Dorsal ganglion cyst is more obvious with flexion of wrist.
• Volar ganglion is more obvious with extension of wrist.
• Ganglion cyst is usually asymptomatic
• Allen’s test is done to see if the cyst is compromising the circulation in case of a volar cyst.

Treatment :

• Surgery – for severe symptoms, Neuro vascular compromise or if patient is in pain.
• Allen’s test is done to check the blood flow of the hand before doing excision of volar ganglion cyst.