Hand Orthopedics Wrist Ganglion Criteria Calculator

About wrist ganglion cysts

A ganglion cyst is a benign swelling filled with thick, jelly-like mucin. It grows out of a joint capsule or a tendon sheath, and it is the soft-tissue mass you will see most often in the hand and wrist. Most of them sit on the back of the wrist: the dorsal ganglion makes up roughly 65% of wrist ganglia and usually traces back to the scapholunate ligament. The volar wrist ganglion is less common, somewhere around 3-20%, and it forms near the volar radiocarpal joint right next to the radial artery, which is why you want to look at it carefully before doing anything to it.

Clinical criteria and how it is assessed

In most cases you can diagnose it on examination alone. The classic signs that this calculator draws on are what help you tell a plain ganglion apart from other masses:

• A firm, smooth, rounded mass that feels rubbery, moves under the skin, and sits below skin that looks normal.
• Transillumination: hold a penlight against the lesion and watch the light pass through, which confirms it is a fluid-filled cyst. A solid tumor blocks the light.
• The size changes over time, and it often tracks with how the wrist is positioned or how much it is being used.
• Mild aching or some weakness. A small "occult" dorsal ganglion can hurt well before you can actually see it.
• With volar lesions, feel whether the mass is pulsatile. That helps you rule out a radial artery aneurysm.

Imaging fills in the rest. Radiographs usually come back normal, ultrasound picks up a hypoechoic cystic structure, and MRI is very reliable when the lesion is multiloculated.

Who uses this

Hand and orthopedic surgeons reach for structured criteria, and so do emergency and primary-care physicians, residents and physiotherapists. They use them to write up a suspected ganglion, to weigh watchful waiting against aspiration or excision, and to walk the patient through the options.

FAQ

Are ganglion cysts cancerous? No, they are benign, and a lot of them clear up on their own with no treatment at all.

Why is transillumination useful? The cyst is full of fluid, so light passes straight through it. A solid tumor won't let that happen.

This tool is educational only and does not replace a medical evaluation. Have any wrist mass looked at by a qualified clinician before aspiration or surgery, and be especially quick about it if the lump is painful, growing, pulsatile or otherwise unusual.