Summary
Definition
History and exam
Key diagnostic factors
- subcutaneous wrist mass
- wrist pain
- nontender mass
- increased mass size after activity
- transilluminating mass
Other diagnostic factors
- unable to recall onset of lump
- hand or finger coolness
- paresthesia or weakness of fingers
- reduced sensation in the hand
Risk factors
- female sex
- age 10 to 30 years
- trauma
- scapholunate instability
Diagnostic tests
1st tests to order
- no initial test
Tests to consider
- cyst aspiration
- erythrocyte sedimentation rate
- C-reactive protein
- complete blood count
- wrist x-ray
- ultrasound
- magnetic resonance imaging
Treatment algorithm
without neurovascular compromise
with neurovascular compromise
Contributors
Authors
Philip Blazar, MD
Associate Professor of Orthopedic Surgery
Harvard Medical School
Brigham and Women's Hospital
Boston
MA
Disclosures
PB declares that he has no competing interests.
Acknowledgements
Dr Philip Blazar would like to gratefully acknowledge Dr Marco Rizzo and Dr Kristofer S. Matullo, previous contributors to this topic.
Disclosures
MR and KSM declare that they have no competing interests.
Peer reviewers
George Chloros, MD
Fellow
Department of Orthopedic Surgery
Wake Forest University Baptist Medical Center
Winston-Salem
NC
Disclosures
GC declares that he has no competing interests.
Lorenz Buchler, MD
Senior Physician
Clinic for Orthopedic Surgery
University Hospital Bern
Bern
Switzerland
Disclosures
LB declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
American College of Radiology. ACR appropriateness criteria: soft tissue masses. 2022 [internet publication].Full text
American College of Radiology. ACR appropriateness criteria: chronic hand and wrist pain. 2023 [internet publication].Full text
Lee I. Clinical treatments for wrist ganglia. ASERNIP-S Report No. 63. Adelaide, South Australia: ASERNIP-S, October 2008 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Carpal tunnel syndrome
- Lipoma
- Giant cell tumor of the tendon sheath
More DifferentialsGuidelines
- ACR appropriateness criteria: chronic hand and wrist pain
- ACR appropriateness criteria: soft tissue masses
More GuidelinesPatient information
Carpal tunnel syndrome
More Patient information
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