What type of doctor treats arm cysts?

Arm Cysts: Specialist Referral

For arm cysts, initial evaluation and management should be performed by an orthopedic surgeon or hand surgeon, as these specialists have expertise in diagnosing and treating soft tissue masses of the upper extremity. 1, 2

Initial Evaluation Pathway

Primary care physicians can initiate the diagnostic workup, but definitive management typically requires specialist involvement:

• Orthopedic surgeons or hand surgeons are the primary specialists for arm cysts, particularly ganglion cysts which represent the most common soft-tissue mass in the hand, wrist, and arm 2
• These specialists can perform both diagnostic procedures (aspiration, transillumination) and definitive surgical treatment when indicated 2

When to Refer to Specific Specialists

Orthopedic/Hand Surgery Referral

• Immediate referral is warranted when imaging features suggest atypical characteristics, progressive pain, or concern for neoplastic etiology 3
• Elective referral is appropriate when patients desire definitive treatment after failed conservative management or for cosmetic concerns 1

Radiology Consultation

• Ultrasound specialists should be consulted when typical cysts require confirmation or when atypical features are present on initial imaging 4
• MRI evaluation is reserved for cases with neurologic symptoms, occult ganglions, intraosseous ganglions, or when solid tumors including sarcoma remain a concern 2, 4

Clinical Decision Points

Diagnosis relies primarily on history and physical examination with specific attention to:

• Location and consistency of the mass (soft tissue swelling, transillumination positive) 1, 2
• Associated symptoms: pain, weakness, paresthesia, or neurologic deficits 1, 2
• Duration and progression of symptoms 3

Imaging is indicated to:

• Evaluate for associated degenerative joint disease 2
• Rule out solid or heterogeneous masses 2
• Precisely locate the cyst and its origin before surgical planning 4

Treatment Approach by Specialist

Conservative management can be initiated by primary care but should be coordinated with orthopedic consultation:

• 58% of ganglion cysts resolve spontaneously over time, making observation a reasonable first-line approach 1
• Over 50% of patients may achieve cyst resolution with nonsurgical management 2

Surgical excision by orthopedic/hand surgeons is indicated when:

• Patients prioritize lower recurrence rates (7-39% with surgery vs. higher rates with aspiration) 2, 5
• Cosmetic concerns are primary 1
• Conservative treatment has failed and symptoms persist 1

Important caveat: Surgical intervention does not provide better symptomatic relief compared to conservative treatment, so if symptom relief is the primary concern, conservative approaches are preferred 1