Most common soft tissue tumor of the hands and wrists
Most common at scapho-lunate joint dorsally
More common in women
20-50 years of age
Contain highly viscous mucin
Clinical Findings
Usually asymptomatic
Symptoms might include
Limitation of motion
Pain
Imaging Findings
Conventional radiographs may be obtained to exclude any other pathology
Cysts are usually not visualized
MRI can further characterize cyst, if needed
Low signal on T1
High signal on T2
May enhance with gadolinium peripherally
Treatment
Aspiration or excision if symptomatic
Cysts can recur (up to 50%) with aspiration
Cysts can be and were treated by thumping them with a large book (closed rupture) and, since a bible was often used, the cyst was called a “bible bump”
Complications
Recurrence
30-60% after non-surgical treatment
5-15% with surgical treatment
Ganglion Cyst. Soft tissue mass on dorsum of wrist, while not pathognomonic, is in the correct location and the appropriate size for a ganglion cyst. There are no bony abnormalities to suggest another diagnosis.
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