Ganglion cyst

Background

• Cystic collection of synovial fluid within a joint or tendon sheath
• ~33% resolve spontaneously

Clinical Features

• May appear quickly, recede, change in size
• Most are not painful
• Interference with function, poor cosmetics, and pain may require routine referral to hand surgeon

Ganglion cyst

Differential Diagnosis

Hand and finger injuries

• Radiograph positive
  • Hand and finger fractures
  • Hand and finger dislocations
  • Triquetrolunate ligament instability
• Radiograph negative
  • Dupeytren contracture
  • Boutonniere deformity
  • Hand and finger tendon injuries
  • Ganglion cyst
  • De Quervain tenosynovitis
  • Intersection syndrome
  • Drummer's wrist
  • Extensor digitorum tenosynovitis
  • Vaughn Jackson syndrome
  • Snapping Extensor Carpi Ulnaris
  • Compressive neuropathy, "bracelet syndrome"
  • Scaphoid fracture
  • Osteoarthritis
  • Infiltrative tenosynovitis
  • Gout
  • Rheumatoid arthritis
  • Trigger finger
  • Mallet finger
    • Swan neck deformity
  • Jersey finger
  • Jammed finger
  • Subungual hematoma
  • Fingertip laceration
  • Metacarpophalangeal (MCP) ulnar ligament rupture (Gamekeeper's thumb)
  • Nail avulsion
  • High-pressure injection injury

Evaluation

• Normally clinical
  • May use ultrasound if unsure

Management

• NSAIDs
• Refer to hand surgeon for persistent or recurrent pain or cosmetic deformity

See Also

• Hand and finger diagnoses

References

Authors

Ross Donaldson, Kevin Lu, Daniel Ostermayer, Neil Young