Wrist Ganglion
A fluid-filled lump at the wrist that needs ultrasound confirmation and a clear treatment strategy.
A wrist ganglion is a benign fluid-filled cyst arising from a joint capsule or tendon sheath, often on the back of the wrist. It may change size, ache during wrist extension or loading, irritate nearby nerves, or simply be bothersome because of how it looks. My consultation starts with clinical assessment and ultrasound to confirm that the lump is truly a ganglion, define its relation to tendons, vessels, and nerves, and exclude other lesions. If the ganglion is symptomatic, recurrent, or functionally or cosmetically troublesome, I usually recommend mini-access surgical excision after ultrasound diagnosis rather than repeated aspirations, because puncture does not remove the stalk and recurrence is common.
Symptoms
- Visible lump on the wrist
- Pain with wrist extension or loading
- Pressure discomfort when leaning on the hand or wearing a watch
- Occasional tingling or weak grip if nearby structures are irritated
Conservative treatment
- Clinical examination and ultrasound confirmation
- Observation when painless and not enlarging
- Temporary splinting and activity modification
- Selected aspiration only in carefully chosen cases
When is surgery needed?
After ultrasound confirmation, symptomatic or recurrent ganglions are often best treated by mini-access surgical excision with removal of the cyst and its stalk.