II. Epidemiology

  1. Most common Soft Tissue Mass in the hand
  2. Adults affected most commonly
  3. Peak ages
    1. Adults age 20 to 40 years old are most commonly affected
    2. Young children may be affected
      1. Subsides by age 2 to 3 years in most cases

III. Pathophysiology

  1. Cyst is an outpouching of the synovial joint capsule and contains mucinous material
  2. Stalk attaches cyst to tendon sheath or joint

IV. Findings

  1. Freely movable mass over joint or tendon
  2. Ganglion Cysts are typically painless, fluid-filled masses
    1. Transillumination or Bedside Ultrasound can confirm fluid-filled mass
  3. Local pain or weakness
    1. Occult Ganglion Cyst may cause regional pain (e.g. dorsal Wrist Pain)
    2. Ganglion may be hidden by overlying extensor tendon
  4. Distribution
    1. Hand and Wrist
      1. Dorsal wrist most commonly affected (esp. near scapholunate joint, 70% of cases)
        1. Ganglion Cyst more prominent with wrist flexed
      2. Volar wrist (20% of cases)
      3. Digital flexor tendon
      4. Digital Mucous Cyst (DIP Joints)
    2. Other, less common, Non-wrist sites
      1. Foot
      2. Knee
      3. Shoulder
      4. Spine

V. Management

  1. Ganglion Cyst Aspiration
  2. Compression dressing applied for 48 to 72 hours
  3. Consider Splinting wrist for several days
  4. Indications for Surgical excision of Ganglion Cyst
    1. Symptoms persist
    2. Despite aspiration and steroid injection 1 to 2 times

VI. Course

  1. Spontaneous resolution without treatment: 53%
  2. Recurrence within 2 to 5 years after treatment
    1. Recurrence after surgical excision: 42%
    2. Recurrence after aspiration: 47%
  3. References
    1. Dias (2003) J Hand Surg 28:172-6 [PubMed]

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Related Studies

Ontology: Synovial Cyst (C0085648)

Definition (CHV) tumor-like lesions at joints, developed from the SYNOVIAL MEMBRANE of a joint
Definition (CHV) tumor-like lesions at joints, developed from the SYNOVIAL MEMBRANE of a joint
Definition (CHV) tumor-like lesions at joints, developed from the SYNOVIAL MEMBRANE of a joint
Definition (CHV) tumor-like lesions at joints, developed from the SYNOVIAL MEMBRANE of a joint
Definition (CHV) tumor-like lesions at joints, developed from the SYNOVIAL MEMBRANE of a joint
Definition (MSH) Non-neoplastic tumor-like lesions at joints, developed from the SYNOVIAL MEMBRANE of a joint through the JOINT CAPSULE into the periarticular tissues. They are filled with SYNOVIAL FLUID with a smooth and translucent appearance. A synovial cyst can develop from any joint, but most commonly at the back of the knee, where it is known as POPLITEAL CYST.
Concepts Disease or Syndrome (T047)
MSH D013581
ICD9 727.40
ICD10 M71.3
SnomedCT 123250005, 71307009, 270543007, 156687004, 202937001, 240205003
English Cysts, Synovial, Cyst, Synovial, Synovial cyst unspecified, Synovial cyst, unspecified, synovial cyst (diagnosis), synovial cyst, Synovial cyst (morphologic abnormality), Synovial cysts, Synovial cyst NOS, Synovial Cyst [Disease/Finding], Cyst;synovial, ganglion cyst, ganglion, myxoid cyst, synovial cysts, Cyst - synovial, Synovial cyst unspecified (disorder), Synovial Cysts, Synovial Cyst, Synovial cyst, Synovial cyst (disorder), cyst; synovial, synovial; cyst, Synovial cyst, NOS, Synovial cyst -RETIRED-
Dutch niet-gespecificeerde synoviumcyste, cyste; synoviaal, synoviaal; cyste, synoviumcyste, Ganglion, Synoviale cyste
French Kyste synovial, non précisé, Kystes arthrosynoviaux, Kyste arthrosynovial, Kystes synoviaux, Kyste synovial, Kyste arthro-synovial, Kystes arthro-synoviaux
German Synovialzyste, unspezifisch, Synovialzyste, Myxoidzyste, Synoviale Zyste
Italian Cisti sinoviale non specificata, Cisti sinoviale
Portuguese Quisto sinovial NE, Quisto sinovial, Cisto Sinovial
Spanish Quiste sinovial no especificado, quiste sinovial (anomalía morfológica), quiste sinovial - RETIRADO -, quiste sinovial, no especificado, quiste sinovial, no especificado (trastorno), quiste sinovial (trastorno), quiste sinovial - RETIRADO - (concepto no activo), quiste sinovial, Quiste sinovial, Quiste Sinovial
Japanese 詳細不明の滑液嚢腫, 滑液嚢腫, カツエキノウシュ, ショウサイフメイノカツエキノウシュ, 滑膜嚢胞, 滑膜のう胞, 嚢胞-滑膜
Swedish Synovialcysta
Czech synoviální cysta, Neurčení synoviální cysta, Cysta kloubní výstelky
Finnish Synoviaalikysta
Russian SINOVIAL'NAIA KISTA, MIKSOIDNAIA KISTA, МИКСОИДНАЯ КИСТА, СИНОВИАЛЬНАЯ КИСТА
Croatian Not Translated[Synovial Cyst]
Polish Torbiel błony maziowej, Torbiel maziówkowa, Torbiel kaletki
Hungarian Synovialis cysta, nem meghatározott, Synovialis cysta
Norwegian Synovialcyste