Adjacent bones are separated by a space or potential space called a joint. The joint space contains fluid & its boundaries consist of cartilage covering the bones & ligaments which connect adjacent bones. The ligaments can weaken forming small outpouches or sacs. The joint fluid within theses sacs becomes concentrated until the fluid is of a gel like consistency. This then is a ganglion cyst. Often there is one main cyst & a few other ones that have not come to the surface.
Although these cysts are benign they are associated with later onset of arthritis especially if the cysts appear early in life. The most common place to see a ganglion cyst is the back of the wrist. Ganglion cysts of the wrist area especially if they arise from more than one joint can be the harbringers of bad wrist arthritis with collapse of the wrist bones. This is due to the weakness of the ligaments in the wrist joints. If the ganlions become large they can impinge on adjacent nerves or affect adjacent tendons.
- Treatment consists of:
- sucking out the gel with a needle – very high recurrence rate
- rupturing the cyst with a book – a bible was used in the old days, but this also has a high recurrence rate creating multiple cysts from a single cyst
- surgical excision with removal of the lax ligamentous tissue which also has a high recurrence if only the main cyst is removed leaving behind smaller cyst(s)