Ganglions are small sacs of clear fluid, called cysts, that can develop on the joints in the hands and wrists, especially around ligaments and tendons. These cysts are benign and can also crop up around around the ankles, feet, ankles, and other major joints in the body. Ganglions typically grow in and around joint capsules in an attempt to cushion preexisting joint irritation or arthritic conditions.
Ganglions appear suddenly and can vary in size, from the circumference of a pea at their smallest to an inch in diameter at their largest. They increase in size during physical activity that involves strenuous joint movement and can be painful if they press against a nerve in the joint. While anyone can develop ganglions, people between the ages of 15 and 40 are most susceptible, and preadolescent children rarely develop them.
Causes of Ganglions
While experts have not yet found a decisive cause of ganglion growth, joint irritation and certain arthritic conditions can increase the likelihood of developing ganglions. When the tough ligaments and tissue that surround the joint become out of place, these small cysts grow like tiny, clear waterballoons on the ends of the joints to decrease the amount of friction between bones and tendons. Other potential factors in developing ganglions include:
- Suffering a joint injury, especially one that knocks the joint or ligaments out of their original position.
- Arthritic conditions, particularly osteoarthritis, which expedites the deterioration of joints in the body.
- Overuse of joints, particularly when physical activity that is strenuous on the joints is done frequently and repetitively.
Symptoms of Ganglions
Ganglions as small, round cysts of circular fluid that gather around irritated or strained joints. They are not cancerous and usually are only painful if they press up against a nerve in the joint. Ganglions’ most common characteristics include:
- Location on the body: Ganglions only cluster around the tendons in the body’s joints, most commonly the hands, wrists, feet, and ankles.
- Appearance: Ganglions are small, round or oval in size, and full of a clear liquid. Size varies but rarely exceeds one inch in diameter, and some ganglions are so small that they can go entirely unnoticed. The fluid itself is clear, thick, and translucent.
- Pain: While pain is not standard for all cases of ganglion, some pain, numbness, or tingling may occur in cases where the cyst presses up against a nerve in the joint.
- Transillumination: One of ganglions’ most tell-tale characteristics, the ability to shine a small light through the cyst will make it apparent that the growth is full of clear liquid and is therefore likely a ganglion.
Your doctor may conduct any of the following tests to rule out other joint and topical conditions and confirm that you have ganglions:
- Transillumination: If your doctor is able to shine a light clearly through the cyst, he can confirm that it is a ganglion full of clear fluid and not a solid mass.
- Applying pressure: Your doctor may light press against the cysts to gauge tenderness, size, and location of the ganglions.
- Imaging tests: An X-ray, MRI, or ultrasound can rule out other potential joint issues and conditions, especially osteoarthritis and certain joint injuries that can cause the same symptoms that ganglions do.
- Taking samples: If other tests prove inconclusive, your doctor may remove some fluid, called aspirate, from the cyst in order to test it and confirm the growth is a ganglion.
Though ganglions are benign and usually go away on their own, several treatment options are available for people whose ganglions are painful, unsightly, or interfering with joint movement. If the recommended watch-and-wait approach does not work, your doctor will likely recommend one of the following treatment methods:
- Draining (aspiration): A popular mode of treatment for ganglions, aspiration is the draining of the fluid sac with a needle or syringe. This will “deflate” the ganglion and decrease the amount of pressure put on tendons and nerves in the affected joint.
- Immobilization: In order to decrease the amount of friction, pressure, or irritation the ganglion may have on the joint area, your doctor may recommend a wrist brace or splint, which will also relieve the pain and help expedite the deflation of the cyst.
- Surgery: When other treatment methods don’t work, surgery may be an effective choice. Your doctor will surgically remove the cyst from the joint tendon it has latched onto. Keep in mind that even if the surgery is effective, ganglions are recurring and may return to the same joint at a later date.