Ganglion

What is a ganglion?

A ganglion is a fluid-filled lump that arises from a joint or tendon sheath. They're most commonly seen at the wrist — on the back or front — but can occur in other locations too. They contain a thick, jelly-like fluid similar to what's found inside a joint.

Ganglia are not tumours. They're benign and don't transform into anything sinister. The exact reason they form isn't always clear, but they sometimes follow minor trauma or develop without any obvious cause.

In children and adolescents, ganglia are particularly likely to come and go — appearing, growing, shrinking and sometimes disappearing entirely on their own.

What does it feel like?

Symptoms vary widely. Some ganglia cause no problems at all and are noticed only because of the lump. Others produce:

• A visible or palpable lump that may change size over time

• Mild aching or discomfort

• Pain with certain wrist movements or with pressure on the lump

• Occasionally restriction of movement, depending on size and location

• A sense that the lump becomes more prominent with activity

Most ganglia are firm but not rock-hard. They may transilluminate (light passes through them) — a useful clinical clue.

How is it diagnosed?

Diagnosis is usually straightforward and based on examination. The location, feel and behaviour of the lump make the diagnosis clear in most cases.

Ultrasound is sometimes useful to confirm the diagnosis and exclude other conditions. MRI is occasionally used for ganglia in less typical locations.

It's worth confirming the diagnosis because not every lump in the hand or wrist is a ganglion — other conditions can mimic them, and the management is different.

What are the treatment options?

Many ganglia in children resolve without any treatment. Watchful waiting is often the right first approach, particularly when symptoms are minimal.

Aspiration (drawing the fluid out with a needle) is sometimes used but recurrence is common. Surgical excision has the lowest recurrence rate and is considered when symptoms are persistent or significantly affecting hand function. Whether any active treatment is right is something Nev will work through with you and your child at your consultation.

When should you get it checked?

Seek a specialist assessment if:

• There's a persistent lump on the hand or wrist

• The lump is causing pain or restricting movement

• It's growing or changing in concerning ways

• You're unsure whether it's actually a ganglion

• You'd like to discuss whether and when treatment makes sense

Ganglia are usually benign and often manageable without surgery — but a clear diagnosis gives families confidence and ensures nothing else is being missed.