Diagnosis:

A ganglion usually is obvious but it is not uncommon to have deep ganglions which are picked up on a MRI scan/ Ultrasound scan.

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Treatment:

Ganglion cysts are harmless and can safely be left alone. Many disappear spontaneously and many others cause little trouble.  There are no long term consequences from leaving the ganglion untreated.

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An ultrasound guided aspiration with a needle and steroid can be considered if the ganglion is symptomatic. 

 

Generally recommendations for treatment will depend on the location of the cyst and on the symptoms that it is causing.

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Surgery:

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Dorsal wrist ganglion cyst.

Often disappears spontaneously. Needle aspiration is used for treatment but recurrence rates are upto 50%. The risk of recurrence after surgery is around 10%.  Other complications after surgery include persistent pain, loss of wrist movement and painful trapping of nerve branches in the scar

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Palmar wrist ganglion cyst.

The risk of recurrence after surgery is around 30%, and problems after surgery include persistent pain, loss of wrist movement and trapping of nerve branches in the scar and the radial artery is close by. For these reasons, many surgeons advise against operation for these cysts.

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Flexor tendon sheath ganglion cyst.

A small pea sized lump on your palm causing pain when gripping.  Puncture of the cyst with a fine needle can disperse it less than 50% recur. Persistent cysts can be removed surgically and the risk of recurrence is small.

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Dorsal digital ganglion cyst.

Usually in associated with early osteoarthritis of the end joint of your finger. Pressure from the cyst may cause a furrow in the fingernail. The risk of recurrence after surgery is around 10% and problems after surgery include infection, stiffness and pain from the arthritic joint.

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