Ganglions

Topic Overview

What are ganglions?

Ganglions are small sacs (cysts) filled with clear, jellylike fluid that often appear as bumps on the hands and wrists. They can also develop on feet, ankles, knees, or shoulders. They are not cancerous. A ganglion can grow out of a joint capsule, which surrounds and protects the joint, or a tendon sheath, which covers the tendon (the ropelike fibers connecting muscle to bone). Most people with ganglions notice that the bumps appear suddenly.

See a picture of a ganglion .

Ganglions may be as small as a seed or larger than a cherry. A ganglion on the leg may get as big as 4 in (10.2 cm). Ganglions may grow as activity increases, because more fluid collects in the sac. They may also shrink and may break and go away on their own.

One common type of ganglion, called a mucous cyst, occurs with osteoarthritis of the hands. This type of ganglion is usually found at the joint nearest the fingernail (distal interphalangeal [DIP] joint). The size of mucous cyst ganglions may get as large as a small green pea and may be painful.

Anyone can get a ganglion: adults between 15 and 40 years old are most likely to be affected.¹ Children do not usually have ganglions, but if they do, the ganglion will very likely go away without any treatment.

What causes ganglions?

Experts do not know the exact cause of ganglions but believe they may be associated with:

• Inflammation or irritation of the tendon sheath or joint capsule.
• An injury.
• Overuse or repetitive motions, such as those you do at work.
• Osteoarthritis (degenerative joint disease), especially mucous cyst ganglions.

What are the symptoms?

Ganglions are usually small, painless bumps, but they may be tender to the touch.

Sometimes there can be pain, which increases with activity or pressure. This may be because the ganglion puts pressure on the nerves that pass near the joint. This pressure on the nerves may also cause tingling in the fingers, hand, or forearm. Some ganglions can weaken your grip or affect joint motion.

How are ganglions diagnosed?

A ganglion can usually be diagnosed by its appearance and location. Your doctor will also feel the bump and shine a light alongside it. If the bump is a ganglion, the light usually shines through it (transillumination).

An X-ray may be done if your doctor suspects osteoarthritis or injury but will not be done only to diagnose the ganglion. Some of the fluid found in the ganglion may be removed and examined. In rare cases, magnetic resonance imaging (MRI) or ultrasound is used to evaluate unusual ganglions.

How are they treated?

Ganglions usually do not need treatment and often go away on their own. If they are painful, limit activity, press on nerves, or are unsightly, your doctor may recommend nonsurgical treatment, such as wearing a splint, massaging the ganglion to reduce the fluid within the bump, or draining it with a needle and syringe (aspiration). Ganglions can also be surgically removed.

Frequently Asked Questions

Learning about ganglions:	What are ganglions? What causes ganglions? What are the symptoms of ganglions?
Being diagnosed:	How are ganglions diagnosed?
Getting treatment:	How are ganglions treated? How can I manage ganglions at home?

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Author:	Shannon Erstad, MBA/MPH	Last Updated: September 23, 2008
Medical Review:	William M. Green, MD - Emergency Medicine David Pichora, MD, FRCSC - Orthopedic Surgery
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