Ganglion Cysts

Hey Doc, What about this bump? That’s a frequent question in the office of a primary care physician.  It usually happens when the patient is already making their way out of the exam room and is followed by a cursory examination where an opinion is warranted and freely given. Well, maybe not freely.

One bump that draws a little more attention is the ganglion cyst that is often seen at the wrist but can be found virtually anywhere. It is usually a non-painful lump that appears without known injury. It may occur on the dorsum (back) side of the wrist or on the volar (palm) side. This bump is actually a cyst. It is a sac of joint fluid (jelly-like in consistency) that has leaked from the joint out into the surrounding soft tissues. The etiology is usually considered to be from a weakness in the joint capsule itself and an eventual herniation occurs.

This cyst used to be referred to as a Bible bump or Gideon’s disease. This is because in the olden days, grandpa or (when we found out you could actually charge for fixing it) the medical profession, just held your arm down and hit the bump with the largest book in the house, namely the Bible. Why Gideon himself got tagged for it I do not know. It could have been David or Solomon or anybody else in the Bible but probably not Goliath. They are not that big.

Today we approach it with a little more professionalism and grace. We jab it with a sterile, large gage needle and then just push the jelly-like substance out onto the exam table. No, we don’t spread it on toast.

Or since it is usually non-painful, we just leave it alone. We leave that choice up to you. It can be quite the thing to show off at a family gathering or party.