From the Guidelines
Ganglion cysts are the most common type of finger cyst, typically appearing as round, firm, fluid-filled lumps connected to joint capsules or tendon sheaths. These cysts can be accurately identified using ultrasound (US) as the initial diagnostic imaging method, which has proven to be most useful in evaluating small superficial lesions, such as those superficial to the deep fascia 1. The use of US in assessing superficial soft-tissue masses has shown high sensitivity and specificity, with a study by Hung et al demonstrating an overall sensitivity and specificity of 94.1% and 99.7%, respectively 1. Some key characteristics of ganglion cysts that can be identified using US include:
- No or minimal acoustic shadowing
- No or minimal vascularity
- Simple curved echogenic lines within an encapsulated mass
- Fluid content, which can be confirmed using US in the appropriate clinical setting 1 Ganglion cysts commonly occur on the dorsal aspect of the wrist but can also be found on fingers, and are typically benign and asymptomatic, requiring no treatment unless they cause pain, interfere with function, or are cosmetically bothersome. Treatment options for ganglion cysts include:
- Observation
- Aspiration with a needle (though recurrence is common)
- Steroid injection to reduce inflammation
- Surgical excision for persistent or problematic cysts It's worth noting that ganglion cysts sometimes resolve spontaneously, and US can be helpful in differentiating a localized mass from diffuse edema and in differentiating a solid from a cystic lesion 1.
From the Research
Types of Finger Cysts
- Ganglion cysts are the most common soft-tissue mass in the hand and wrist, and can be found at various locations, including:
Characteristics of Ganglion Cysts
- Ganglion cysts are benign soft tissue tumors that commonly occur in the joints, especially the wrist 5
- They can cause symptoms such as swelling, pain, weakness, or paraesthesia 5, 6
- The cysts are more common in younger patients, with a higher incidence in females 5
- The cysts can be asymptomatic, but patients may be concerned about their cosmetic appearance and the fear of future malignant growth 6
Diagnosis and Treatment of Ganglion Cysts
- Diagnosis relies primarily on history and physical examination, with transillumination and aspiration of masses as useful adjuncts 2
- Imaging such as radiography, ultrasonography, and MRI may be indicated to evaluate for associated conditions or to rule out a solid or heterogeneous mass 2, 4
- Treatment options include observation, aspiration or puncture with possible corticosteroid injection, and surgical excision 2, 5, 6
- Surgical excision has been shown to have a higher success rate and lower recurrence rate compared to aspiration and steroid injection 5
- Arthroscopic excision has shown promising results with low recurrence rates 3, 4