A fluid-filled lump arising from a wrist joint or tendon sheath. Many resolve without treatment — aspiration and arthroscopic excision when symptomatic.
What is Ganglion Cyst?
A ganglion cyst is a benign, fluid-filled swelling that arises from a joint or tendon sheath. The wrist is the most common site — dorsal (back of wrist) and volar (palm side) ganglions are most frequent. Ganglions can also form at the base of a finger (mucous cyst near a finger joint) or over the flexor tendon sheath.
Ganglions develop when synovial fluid leaks through a one-way valve in the joint capsule or tendon sheath, forming a fluid-filled sac. They may enlarge with activity and shrink with rest. Most are harmless but can cause pain, cosmetic concern, or tingling if pressing on a nerve.
Symptoms
Symptoms
Visible or palpable lump, most commonly on the back of the wrist
Ultrasound to confirm diagnosis and assess relationship to joint
MRI for occult ganglions or complex presentations
Aspiration for diagnosis and treatment simultaneously
Non-surgical Treatment
Non-surgical options
Observation — many ganglions resolve spontaneously within 1–2 years
Activity modification to reduce aggravating movements
Aspiration (needle drainage) under local anaesthetic
Ultrasound-guided aspiration for volar ganglions near the radial artery
When to consider surgery
Arthroscopic ganglion excision removes the cyst and its stalk through small wrist portals under direct visualisation, with lower recurrence rates than aspiration (5–10% vs 30–40%). Open excision remains the option for volar or recurrent cysts and for mucous cysts at the finger joint.
Arthroscopic excisionDay surgeryLocal or regional anaestheticLow recurrence rate
Recovery Expectations
Typical recoveryAspiration: return to normal activity in 1–2 days. Arthroscopic excision: light activities 1–2 weeks, full recovery 4–6 weeks. Open excision: 4–6 weeks recovery. Recurrence after surgery is uncommon.
When to see a Hand Surgeon
Seek specialist assessment if:A wrist lump that is painful or affecting function. A lump that is enlarging or cosmetically concerning. Tingling in the fingers associated with a wrist lump. Uncertainty about the nature of a wrist lump.
Frequently asked questions
Common questions about ganglion cyst, answered by Dr David Ma.
Not necessarily. Many ganglions are painless and resolve without treatment. Surgery is appropriate when the cyst causes persistent pain, limits function, or is cosmetically bothersome.
Arthroscopic excision has a recurrence rate of approximately 5–10%, compared to 30–40% after aspiration alone. Recurrence is lowest when the stalk is removed at its root within the joint.
Aspiration is performed under local anaesthetic and is generally well tolerated. The cyst may refill over time in 30–40% of cases.
Ganglion cysts are benign and do not become cancerous. However, any new wrist lump should be assessed to confirm the diagnosis and exclude other causes.
A GP referral is recommended for Medicare rebates but not required to book.
Dr David Ma treats ganglion cysts at accredited Sydney facilities.
Consultations at Chatswood (North Shore — Lane Cove, Willoughby, Artarmon, St Leonards, Gordon)
and Strathfield (Inner West — Burwood, Homebush, Rhodes, Concord, Auburn, Newington).
Call (02) 8112 8569 or email admin@drdavidma.com.
