Mucous Cyst
What is a mucous cyst?
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A mucous cyst (also known as a ganglion) of the small joint of the finger is a harmless swelling filled with joint fluid.
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Mucous cysts occur in people over 40 years of age and are associated with early underlying arthritis.
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The cyst may put pressure on the growing part (germinal matrix of the nailbed) and cause grooving of the nail.
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It is uncommon to have more than one mucous cyst.
What causes mucous cysts?
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Mucous cysts occur due to increased fluid that occurs when there is mild or moderate arthritis of the joint.
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Small bone spurs that occur with arthritis can weaken the capsule that keeps the fluid inside the joint. The fluid forms a cyst under the skin.
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These cysts often change in size and may disappear spontaneously. For this reason, if the ganglion is not symptomatic, there is no urgency to consider surgery.
Mucous/ganglion cyst
Bone spurs (osteophytes)
What are the signs & symptoms?
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A swelling over the smaller joints of the hand.
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Nail grooving may occur.
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Pain - mucous cysts are prominent and uncomfortable when knocked during daily activities.
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Occasional redness
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The cysts often leak a thick gel onto the nail and decrease in size for a time then gradually swell again.
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The cyst can be uncomfortable when large or when traumatised during daily activities.
Treatment
Non-operative treatment
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There is no effective non-operative treatment .
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Trying to drain the cyst by inserting needles can result in septic arthritis vecause the cyst connects to the joint.
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Mucous/ganglion cysts are harmless so there is no need to treat them if there are no symptoms.
Surgical excision of the mucous/ganglion cyst
This is a small day surgery procedure performed under local or general anaesthetic. The mucous cyst is removed and so are any bone spurs (osteophytes) that may be present. It can be performed under general or local anaesthetic with sedation. Removing the bone spurs stimulates a healing response and fibrous tissue formation to prevent the ganglion recurring. A bulky bandage is applied to finger and extends to the wrist.
Recovery
2 days
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Keep hand elevated and take pain relief prescribed.
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May recommence driving.
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The wound is kept dry for the first 2 weeks by showering with a plastic bag or over-sized kitchen glove.
2 weeks
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The bandage and the stitches are removed.
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May shower hand normally.
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The finger will still be swollen for several weeks.
IMPORTANT - Follow these instructions until finger movement is normal.
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Regular panadol osteo three times daily .
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Self Stick Compression Bandage to control the swelling.
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Use heat before exercises - heatpack, shower or warm water.
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Exercise the finger for 5 minutes 3 times daily
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Make a fist
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Hold first finger joint straight & bend fingertip only
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Make a "claw" (knuckles straight, small joints of finger bent)
8-10 weeks
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Review with surgeon to check on movement.
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Movement should have returned to normal by 8-10 weeks
4 months
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Residual swelling and stiffness resolves.