Ganglion Cyst Home A-Z Health Information Health Library A-Z Ganglion Cyst Overview Ganglion cysts are small fluid-filled swellings usually over the tendon sheaths. They most commonly affect the wrist, ankle, or feet. The cause of ganglion cysts is unknown. Symptoms The patient usually presents with a soft painless swelling over the dorsum of the wrist joint (most common site). Dull aching pain with terminal movements at the wrist joint.Rarely, the swelling compresses the underlying nerves, leading to tingling, numbness, and occasionally muscle weakness. Risk factors Women are more commonly affected than men.High activity at young age (15–40 years).Excessive friction and repetitive stress (like performing gymnastics). Diagnosis Physical examination.Radiography (X-ray) to assess the condition of the underlying joint and identify old pathologies.Ultrasonography or magnetic resonance imaging (MRI) to rule out other causes of swelling and identify the exact anatomy, location, and extent of the cyst to plan treatment. Treatment Non-surgical treatmentConservative management is the initial treatment of choice. It includes:Observation, if there is no pain.Splints, such as a wrist brace to help immobilise the joint, alleviate pain, and decrease swelling.Aspiration is recommended for large swellings affecting daily activities.Surgical treatmentSurgical excision is recommended for patients for whom conservative management has failed. The surgical options are as follows:Open excision to allow access to the complete cyst including the stalk and the wall. However, the chances of cyst recurrence can be up to 40%. A splint is advised for approximately 2 weeks after the surgery following which gradual movements are allowed.Excision through arthroscopy procedure involves minimal incisions and less soft tissue damage and allows enhanced visualisation of the joint (most commonly the scapho-lunate joint) without jeopardising the articular cartilage. However, this technique requires extensive expertise.