Ganglionic Cysts

Question 1

What are ganglionic cysts

Answer 1

non-cancerous soft tissue lumps that occur along any joint or tendon and subsequently are filled with synovial fluid

Question 2

Where are ganglionic cysts most commonly found

Answer 2

Hands and feet

60-70% occur in the dorsal aspect of the wrist

Question 3

What are the risk factors for ganglionic cysts

Answer 3

Female

OA

Previous joint/ tendon injury

Question 4

What are the clinical features of ganglionic cysts

Answer 4

Painless lump adjacent to the affected joint

Lump will transilluminate

Question 5

what are the differential diagnosis

Answer 5

Tenosynovitis

Giant cell tumour of tendon sheath

Lipoma

OA

Sarcoma

Question 6

What are the investigations you would carry out

Answer 6

Clinical diagnosis mainly

X ray to rule out other pathologies

USS or MRI to assess shape and size if needed

Can be aspirated for temporary symptomatic relief - sent for microscopy

Question 7

How do you manage a cyst that causes no pain

Answer 7

Monitor as cysts will often disappear on their own

Question 8

how do you manage a cyst that causes pain

Answer 8

Aspiration +/- steroid injection - associated with high rate of infection

Cyst excision