Ganglion

A benign accumulation of synovial fluid often within a sac with a narrow base which is connected to a joint or a tendon. Can develop in any joint but are very common in/around the wrist joint. Fluctuation in size is common. Most eventually disappear spontaneously.

Mechanism of onset, location of symptoms, type and nature of symptoms, severity and longevity of symptoms, limitation to function.

1. Range of movement and general hand function.
2. Palpate for pain.

None required.

• NHS Inform. Ganglion cyst
• Explanation of cause and natural history
• BSSH patient leaflet
• If pain free and not affecting range of movement and function then advise that these are best left without any intervention.
• Aspiration only of dorsal wrist ganglia, but advise patient that 70% of wrist ganglia will recur within a week.
• Patient to self-monitor.

Consider referral to secondary care if:
Symptomatic - severe pain/sensory symptoms and/or limitation to function.