Ganglion Cysts of the Hand and Wrist in Austin, TX — ATX Orthopedics

A ganglion cyst is one of the most common lumps people discover on their hand or wrist — and one of the most common reasons patients see a hand surgeon. At ATX Orthopedics in Austin, Texas, Dr. Benjamin Amis, MD, a board-certified, fellowship-trained hand and shoulder surgeon, diagnoses and treats ganglion cysts of the wrist, hand, and fingers with both non-surgical and surgical approaches.

What Is a Ganglion Cyst?

A ganglion cyst is a benign (non-cancerous) fluid-filled sac that arises from the lining of a joint or tendon sheath. The fluid inside is a thick, gel-like substance similar in composition to joint fluid. Ganglion cysts are the most common soft tissue masses of the hand and wrist, accounting for approximately 60–70% of all hand and wrist lumps seen by hand surgeons.

The cyst typically looks like a smooth, round bump under the skin. It may be firm or soft, and its size can fluctuate — often shrinking with rest and enlarging with activity. In some cases it disappears entirely on its own, only to return later.

Where Do Ganglion Cysts Form?

The most common locations include:

• Dorsal wrist (back of the wrist) — the most common location, arising from the scapholunate ligament
• Volar wrist (palm side) — arising near the radial artery; requires careful surgical planning due to proximity to the artery
• Flexor tendon sheath (base of the finger, palm side) — called a “seed ganglion” or “retinacular cyst”; usually small but tender with gripping
• Distal interphalangeal (DIP) joint of the finger — called a mucous cyst; associated with underlying arthritis and may cause nail deformity if adjacent to the nail matrix

What Causes a Ganglion Cyst?

The exact cause is not completely understood. Current evidence suggests that ganglion cysts develop through a defect or degeneration in the joint capsule or tendon sheath, allowing joint fluid to seep out and pool under the skin. They are not caused by injury in most cases, though trauma may occasionally precipitate one. They are not cancerous and do not spread.

Symptoms

Many ganglion cysts cause no symptoms at all and are noticed purely as a cosmetic concern. When symptoms do occur, they can include:

• A visible or palpable lump on the wrist, hand, or finger
• Dull aching or discomfort, particularly with activity
• Weakness with gripping
• Numbness or tingling if the cyst compresses a nearby nerve
• Nail deformity (if a mucous cyst at the DIP joint presses on the nail matrix)

How Is a Ganglion Cyst Diagnosed?

Diagnosis is usually clinical. Dr. Amis will examine the lump, assess its location and consistency, and may shine a light through it (transillumination) to confirm the fluid-filled nature. An X-ray may be obtained to check for underlying arthritis (particularly relevant for mucous cysts). Ultrasound or MRI can be used for deeper or atypical presentations.

Treatment Options

Observation (Watch and Wait)

Because ganglion cysts are benign and approximately 40–58% resolve spontaneously over time, observation is a completely reasonable choice for cysts that are small, asymptomatic, or only mildly bothersome. Dr. Amis will help you weigh the benefits and risks of treatment against watchful waiting based on your cyst’s location, size, and symptoms.

Aspiration

Aspiration involves inserting a needle into the cyst to drain the fluid. This can be done in the office and requires only local anesthesia. The procedure is quick and well-tolerated, but recurrence rates are substantial — approximately 50% for dorsal wrist cysts and higher for other locations. Aspiration is often a reasonable first step for patients who prefer to avoid surgery.

Surgical Excision

Surgical excision is the most definitive treatment and offers the lowest recurrence rate (approximately 5–10% for dorsal wrist cysts when the stalk is completely removed). The procedure involves removing not just the cyst but its stalk and the connection to the underlying joint or tendon sheath. It is performed as an outpatient procedure, usually under local anesthesia using the WALANT technique. Most patients return to light hand use within 1–2 weeks.

Surgery is most appropriate for cysts that are symptomatic, large, recurrent after aspiration, or located in sites where recurrence after aspiration is particularly high (such as volar wrist or finger flexor sheath).

Why Choose Dr. Amis at ATX Orthopedics?

Dr. Amis’ fellowship training at the CV Starr Hand Surgery Service in New York City included extensive experience with all types of hand and wrist masses. At ATX Orthopedics, every patient is evaluated by Dr. Amis personally. There are no nurse practitioners or physician assistants routing your care — the surgeon you see in the clinic is the surgeon who will perform your procedure. Our clinic is accessible, and most hand procedures are performed at Pinnacle Surgery Center of Austin, our outpatient ambulatory surgery center in Austin, Texas.

Schedule a Consultation in Austin, TX

If you have a lump on your wrist or hand and want to know whether it is a ganglion cyst and what to do about it, schedule a consultation with Dr. Amis. Book online or call us at (512) 960-4590.

Ganglion Cyst Treatment in Austin, TX

Dr. Benjamin Amis offers ganglion cyst aspiration and surgical excision at ATX Orthopedics in Austin, TX at Pinnacle Surgery Center of Austin.

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