Ganglions are small sacs filled with clear, jellylike fluid often appearing on the hands and wrists, but can also develop on shoulders, feet and ankles as well. They grow out of a joint and rise from the connective tissues between bones and muscles to form a round bump visible from under the skin. The size of the bump will vary depending on the level of activity. Though they are generally painless, increasing activity that causes the ganglion to increase in size could put pressure on nerves and cause pain.

Those at Risk
While the cause of Ganglions is unknown, it is thought to be a reaction to an injury that causes the tendon sheath covering the tendon, or the joint capsule protecting the joint, to form extra fluid and balloon out. Women are more often affected by Ganglions than men. And they are common among gymnast, who repeatedly place weight and stress on the non weight-bearing wrist joint.

Diagnosis
While Ganglions are rarely painful a physical examination will help determine the best treatment plan. An X-ray may be indicated in order to eliminate the possibility of arthritis or a bone tumor. And occasionally an MRI or ultrasound is used to find ganglions hidden under the skin.

Treatment
With these types of conditions, the first treatment options considered are always conservative and non surgical. This may include a period of observation, perhaps combined with period of immobilization with a wrist brace or splint – in order to relieve any pain or tenderness.

If the ganglion causes significant pain or interferes with daily activities, aspiration may be considered in order to remove the fluid.

If the cysts continue to grow, outpatient surgery can remove it as well as a portion of the affected joint capsule or tendon sheath – with a normal resumption of activities in two to six weeks.