Ganglia are very common swellings in the wrist and in the fingers. They arise from the capsules of joints, usually because there is some underlying arthritis or injury that led to the ganglion forming.
Usually, a swelling is noticed, and this may be uncomfortable or painful. However, the pain often arises from underlying arthritis or an injury that led to the ganglion forming.
The most common place to develop a ganglion is at the end joint of the finger. These ganglia can affect nail growth and cause a groove in the nail. These are also known as mucous cysts.
Ganglia can also typically occur on the back of the wrist near the middle (from the joint capsule between the scaphoid and lunate bones), and on the palm side of the wrist on the thumb side.
A tender ganglion cyst (‘pearl ganglion‘) can arise on the palm side of the base of a finger.
An X ray is helpful to look for underlying arthritis, and ultrasound or other imaging may be necessary to confirm the diagnosis or assess the extent of the cyst to help plan treatment.
Cysts can be aspirated with a needle to remove the thick clear jelly-like substance within them. This is a successful long-term treatment in some cases, but most ganglia recur.
Surgical removal is usually successful for the tender pearl ganglia, and the ones on the back of the finger. It is also possible to remove the ganglia on the wrist, but these have high rates of recurrence even after surgical removal. There is a small risk of damaging nerves, and some patients have ongoing pain or loss of wrist movement.
Treatment options and possible outcomes will be discussed fully at your consultation.