Wrist Ganglion Cyst Treatment London | Private Ultrasound Diagnosis & Injections

Wrist Ganglion Cyst Explained

What is a Wrist Ganglion Cyst?

A wrist joint ganglion is the name given to a fluid-filled cyst, which is essentially a herniation of the joint capsule of the wrist joint.

It is most commonly seen on the upper (dorsal) side of the wrist, but can occasionally present on the palm (volar) side of the wrist.

Wrist Ganglion Cyst Symptoms

Symptoms of a wrist joint ganglion cyst are highly variable but normally individuals notice a visible and palpable lump on the dorsal upper side of the wrist joint or in less common circumstance on the palm aspect of the wrist joint. 

Sometimes these cysts may be painful and in other circumstances no pain will be felt. Often wrist joint ganglion cysts are non-traumatic but they may occur after an accident or trauma to the wrist joint or tendons surrounding the wrist. 

Commonly, individuals will complain of an inability to fully extend the wrist due to the congestion felt with the wrist.

What Causes a Wrist Ganglion Cyst?

Wrist ganglion cysts can occur as a result of:

• Trauma to the wrist

• Degenerative changes within the wrist joint

However, in many cases, there may be no obvious causative factor.

Wrist Ganglion Cyst Diagnosis

If the ganglion cyst does not cause pain or functional problems, individuals may choose to leave the condition untreated, as it can sometimes self-resolve.

However, if the cyst causes pain, functional limitation, or is enlarging in size, an ultrasound scan is an excellent diagnostic tool to:

• Assess the nature and size of the ganglion cyst

• Precisely define where the fluid is emanating from

• Exclude other potential causes of wrist swelling

For example, an ultrasound scan may demonstrate a volar wrist radiocarpal ganglion cyst with multiple septations within the cyst. It may be seen emanating from the volar aspect of the wrist and located adjacent to structures such as the flexor carpi radialis tendon and the radial artery, which can be clearly visualised with Doppler ultrasound.

Many wrist ganglions occur on the dorsal side of the wrist, and ultrasound can readily demonstrate a classic dorsal ganglion cyst in this location.

Wrist Ganglion Cyst Ultrasound Guided Injections

Wrist Ganglion Cyst Aspiration & Injection

When the cyst is located on the upper (dorsal) side of the wrist, an ultrasound-guided aspiration of the cyst followed by an injection of corticosteroid can be effectively performed.

This is achieved by visualising the cyst with the ultrasound probe placed on the top of the wrist, and carefully guiding the needle under ultrasound visualisation into the ganglion cyst to perform aspiration and injection.

What to Do After Your Wrist Ganglion Cyst Aspiration & Injection

Needle Path & Post-Injection Pain
Post aspiration and injection of a ganglion cyst of the wrist there may be some soreness for several days dependent on the exact size, nature and location of the wrist. During the procedure an intended consequence of the aspiration and injection is to disrupt the walls of the cyst or burst the contents of the cyst and this or the steroid medication can cause soreness. 

There may some additional soreness due to needle path dependent on the location of the cyst.

Wound Care & Infection Risk
Avoid exposing the needle site to public or dirty water (e.g., swimming pools, hot tubs, lakes) for 2–3 days after any ultrasound-guided injection, due to the small infection risk.

Activity Guidance
After a wrist ganglion cyst aspiration and injection, it is advisable to avoid any significant increase in weight bearing or end of range activity with the wrist for 10-14 days. This allows the anti-inflammatory properties of the steroid to work optimally. Significant laptop/ DSE work may also need to be adapted during this period if this is an aggravating factor.
Following this period, you should engage in a progressive program of physical therapy exercises but should not push the wrist into pain.

Follow-Up
Following a wrist ganglion cyst aspiration and injection, please contact me immediately if you experience any difficulties.

Treatments for Wrist Ganglion Cyst Aspiration & Injections 

Wrist Ganglion Cyst Aspiration & Injections | Evidence base

Wrist ganglion cysts are benign synovial fluid–filled lesions arising from the joint capsule or tendon sheath, most commonly on the dorsal or volar wrist. Many are asymptomatic and may resolve spontaneously, while others cause pain, weakness, or restriction of movement. Evidence supports an initial conservative approach for asymptomatic or minimally symptomatic cysts. 

For patients with persistent pain or functional limitation, ultrasound-guided aspiration, with or without corticosteroid injection, is a commonly used non-surgical option. Ultrasound guidance improves localisation and aspiration accuracy, allows differentiation from vascular or solid masses (particularly important for volar cysts), and reduces the risk of neurovascular injury. While aspiration can provide symptom relief, recurrence rates remain relatively high, and the addition of corticosteroid has not consistently shown a significant reduction in recurrence, though it may reduce post-procedural inflammation. 

Surgical excision offers lower recurrence rates but carries greater morbidity and is typically reserved for recurrent or refractory cases. Overall, ultrasound-guided aspiration is a safe, minimally invasive option for symptomatic wrist ganglion cysts and is best used as part of shared decision-making, with clear counselling regarding recurrence risk.

Wrist Ganglion Cyst Aspiration & Injections | Evidence base

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