Ganglion Cyst

• Idiopathic
• Contains clear fluid similar to synovial fluid
• Most common soft tissue tumor of the hands and wrists
  • Most common at scapho-lunate joint dorsally
• More common in women
  • 20-50 years of age
• Contain highly viscous mucin

Clinical Findings

• Usually asymptomatic
• Symptoms might include
  • Limitation of motion
• Pain

Imaging Findings

• Conventional radiographs may be obtained to exclude any other pathology
• Cysts are usually not visualized
• MRI can further characterize cyst, if needed
  • Low signal on T1
• High signal on T2
• May enhance with gadolinium peripherally

Treatment

• Aspiration or excision if symptomatic
  • Cysts can recur (up to 50%) with aspiration
• Cysts can be and were treated by thumping them with a large book (closed rupture) and, since a bible was often used, the cyst was called a “bible bump”

Complications

• Recurrence
  • 30-60% after non-surgical treatment
• 5-15% with surgical treatment

Ganglion Cyst. Soft tissue mass on dorsum of wrist, while not pathognomonic, is in the correct location and the appropriate size for a ganglion cyst. There are no bony abnormalities to suggest another diagnosis.
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