Wrist
Ganglion Cyst
결절종 (손목 물혹)
Benign fluid-filled cyst arising from joint capsule or tendon sheath
- How common
- Very common (50–70% of wrist masses)
- Typical age
- Women, 20–40
What is it?
Synovial fluid extrudes from joint capsule or tendon sheath, forming a hyaluronic-rich cyst.
Commonly affected: Dorsal wrist (most common), volar wrist, finger flexor sheaths
How it develops
- Capsule WeakeningRepetitive loading creates capsule weak points
- One-way ValveA valve lets synovial fluid escape but not return
- Cyst FormationExtracapsular jelly-filled cyst accumulates
- Fluctuating SizeCyst size fluctuates with activity
Symptoms
- Palpable MassFirm, rubbery, round mass
- Fluctuating SizeChanges with activity level
- Wrist AcheMild discomfort; pain in some
- Grip WeaknessGrip weakness with larger cysts
How it is examined
- TransilluminationCyst transilluminates (confirms fluid)
- PalpationSmooth, rubbery, round
- Non-tender UsuallyUsually non-tender
Imaging
X-ray rules out bony tumor.
- Normal bone
- Soft tissue shadow
US or MRI confirms fluid-filled cyst.
- Unilocular or multilocular cyst
- Often communicates with joint
- T2 hyperintense
Non-surgical care
- ObservationIf asymptomatic — 50% resolve spontaneously
- SplintingShort-term wrist splint for symptom relief
- AspirationAspiration ± steroid — ~50% recurrence
Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.
When surgery is considered
Recurrence, functional impairment, diagnostic uncertainty
Procedures that may be discussed
- Open cyst excision
- Arthroscopic excision (dorsal cysts)
Outlook
50% self-resolve; surgical recurrence 5–15%.