Ganglion Cyst

Ms N is a 4 years old girl who had a fall on her palm two weeks ago was brought by her father showing a small pea-like swelling on the palmar surface of the proximal phalanx of her right little finger.

The swelling was only painful upon palpation. She otherwise had full function and power of her right little finger. It was difficult to tell whether she had the swelling previously as children do not usually complain until there is pain. I suggested an ultrasound of the swelling which should demonstrate a cystic (fluid-filled sac)swelling with some inflammation. I referred her to a Hand Orthopaedic Surgeon for further evaluation and treatment.

Ganglion cysts are the most common lesion of the hand and wrist, accounting for 50% to 70% of all masses identified. The majority of ganglion cysts can be treated nonoperatively but when surgery is performed a low recurrence rate can be anticipated. Giant cell tumor of the tendon sheath hand epidermoid cysts are also common hand lesions that require surgical excision in most instances. Of the three, giant cell tumor of tendon sheath have the most notable recurrence rates. (Nahra etal, 2004)

Usually Ganglion cysts may be treated non-surgically. If it becomes painful or restricts normal function, cyst aspiration and corticosteroid injection may help. Surgical excision usually has low recurrence rate.