Ganglion cysts, also known as Bible cysts, are a frequent cause of confusion for many individuals who suffer from them. Many individuals believe they are a type of cancer as they tend to increase in size and can sometimes cause much disfigurement and discomfort.
What are ganglion cysts?
Ganglion cysts are noncancerous lumps that most commonly develop along the tendons or joints of wrists or hands. Ganglion cysts most commonly occur on the back of the hand at the wrist joint, but they can also develop on the palm side of the wrist. They also occur less frequently in other sites like the feet and ankles. Ganglion cysts are typically round or oval and are filled with a jellylike fluid.
Small ganglion cysts can be pea-sized, while larger ones can be around an inch (2.5 centimeters) in diameter. Ganglion cysts can sometimes reach the size of a table tennis ball. Ganglion cysts can be painful if they press on a nearby nerve. Their location can sometimes interfere with joint movement.
Although most ganglions are harmless, they can sometimes be painful. If they do not cause any pain or discomfort, they can be left alone and may disappear without treatment, although this can take many years.
What causes ganglion cysts?
It is not clear why ganglions form. They seem to occur when the synovial fluid that surrounds a joint or tendon leaks out and collects in a sac.
Risk factors
Factors that may increase your risk of ganglion cysts include:
• Your sex and age. Ganglion cysts can develop in anyone, but they most commonly occur in women between the ages of 20 and 40.
•Osteoarthritis. People who have wear-and-tear arthritis in the finger joints, closest to their fingernails, are at higher risk of developing ganglion cysts near those joints.
• Joint or tendon injury. Joints or tendons that have been injured in the past are more likely to develop a ganglion cyst.
Diagnosis
If you think you might have a ganglion cyst see your doctor. Whether you have symptoms or not, you can benefit from a medical evaluation of the cyst. Your doctor can be sure that you have a ganglion cyst, keep you from worrying, and help decide on the best treatment plan for you.
You doctor will carry out a clinical history and examination.
During the physical exam, your doctor may apply pressure to the cyst to test for tenderness or discomfort. He or she may try to shine a light through the cyst to determine if it is a solid mass or filled with fluid.
Your doctor might also recommend imaging tests — such as X-rays, and ultrasound scan, to rule out other conditions such as arthritis or a tumour.
A ganglion cyst diagnosis may be confirmed by aspiration, a process in which your doctor uses a needle and syringe to draw out (aspirate) the fluid in the cyst. Fluid from a ganglion cyst will be thick and clear or translucent.
Treatment
Treatment is usually only recommended if the cyst causes pain or affects the range of movement in a joint.
The two main treatment options for a ganglion cyst are:
• draining fluid out of the cyst with a needle and syringe – the medical term for this is aspiration
• surgically removing the cyst
Individuals are sometimes encouraged to do some procedures at home that can cause more harm than good. If you have a ganglion cyst you should NOT do the following:
• “Thumping” the cyst with a heavy object like a large book or a Bible. This can cause damage to surrounding structures such as nerves.
• Do not try to “pop” the cyst on your own by sticking it with a needle. This is unlikely to be effective and can lead to infection.
Conclusion
A ganglion cyst is a benign (noncancerous) swelling on top of a joint or the covering of a tendon. They commonly occur on the back of the hand near the wrist joint, but they can occur at other sites. These cysts might cause some pain but, in many cases, they do not cause any discomfort. All ganglion cysts should be evaluated by a doctor who will discuss with you further management. Some cysts disappear on their own, but they are many treatment options available with good results.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG, is an Obstetrician/Gynaecologist and Family Doctor who has over thirty-two years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
