With our hands, we can work, express emotions, serve others, show love or create art. They enable us to carry out daily tasks of self-care: they tie shoes, prepare food, brush hair, and so much more.
Cysts and tumors on the wrist or hand can make these tasks painful and difficult, and can significantly impact quality of life.
Ganglion cyst is treatable
“The type of cyst I see most often is a ganglion cyst, a type of synovial cyst,” says Dr. Benjamin Garner of East Falls Orthopaedics. He is an orthopedic surgeon specializing in hand and wrist conditions and practices at Eastern Idaho Regional Medical Center (EIRMC). “Ganglion cysts are the outpouching of the soft tissue lining the wrist or hand joints. Since pressure is higher inside the joint, it pushes outward and fills the cyst with joint fluid.”
There is no way to predict who will get a ganglion cyst and no specific cause. Anyone, at any time, at any age, can develop one. They tend to fill and shrink on their own, and some spontaneously resolve or rupture. Thankfully, while they can look scary, feel awkward, and are sometimes painful, they are usually harmless and are often treatable.
Help is available
As Dr. Garner explains, “The conservative treatment for a ganglion cyst is to aspirate it [using a needle to draw out the fluid], which can be done in my office. This is often just a temporary solution though; they are notorious for refilling. The next step is minor surgery to dissect down to the origin and remove the cyst itself.”
Joints are not the only parts of the hand and wrist that can form ganglion cysts; tendons can be affected, too. Flexor tendon sheath cysts are ganglions that often form at the base of a finger, on the palm side of the hand.
“Flexor tendons run through a tube (the tendon sheath), which can form an outpouching and fill with fluid,” says Dr. Garner. “It feels like there is a BB under your skin, and it’s painful when you grip. Flexor tendon cysts can wax and wane, and they can spontaneously rupture. They are often amenable to puncture with a needle [done in-office] and don’t usually come back.”
Mucoid/myxiod cysts
Another type of cyst Dr. Garner treats is a mucoid/myxoid cyst, which primarily affects arthritic fingers.
“This type of cyst most often forms near a joint at the end of a finger, often near the nailbed,” says Dr. Garner. “Mucoid cysts are common and can be quite painful because of the sensitive nerves in that area. Like ganglion cysts, mucoid cysts can be aspirated in office or surgically debrided.”
Giant cell tumors
Not all bumps on the hand and wrist are fluid-filled cysts; some are tumors (solid tissue mass). While cysts are very rarely cancerous, tumors can be—but not always. One normally benign type of quasi-tumor that Dr. Garner regularly treats is called a giant cell tumor (GCT), a firm mass that can sometimes form in the hands or fingers. While not cancerous, GCTs grow steadily and can become progressively bothersome if not removed.
As Dr. Garner explains, “A GCT can occur anywhere in the hand or wrist, most commonly the fingers. People don’t usually let them get bigger than a pea or bean because they become very uncomfortable. They grow slowly and keep on growing, and they just have to be surgically removed. There is no way to puncture them, unfortunately.
“About 96% of GCTs are benign. Very rarely are they cancerous,” continues Dr. Garner. “However, I do see skin cancer on hands, sarcomas, and occasionally a metastatic cancer that has spread from somewhere else in the body. So, any lump or bump on your hand or wrist should be evaluated by a doctor, just in case.”
To schedule an evaluation with Dr. Garner, visit East Falls Orthopaedics or call (208) 535-4580.
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