Mucous Cyst

Overview

what it is and why it matters

Palmar dissection of the hand and wrist showing the eight carpal bones, flexor tendons, and median and ulnar nerves. — **Hand and wrist anatomy.** Eight small carpal bones form the wrist and connect the forearm to the five metacarpals of the palm. Finger tendons and the median and ulnar nerves pass through narrow tunnels in the wrist on their way into the hand.

A mucous cyst is a ganglion cyst that arises from the DIP (distal interphalangeal) joint at the fingertip, almost always in association with underlying DIP joint osteoarthritis. The cyst appears as a smooth, tense, translucent dome on the dorsum of the fingertip between the DIP joint and the nail fold. Pressure on the germinal matrix of the nail can cause a longitudinal nail groove.

They are most common in women over 50 and most often affect the middle or index finger.

Diagnosis

exam first, imaging second

Diagnosis is clinical: characteristic location, transillumination, associated DIP arthritis on exam, and often a nail groove. X-ray of the finger confirms DIP joint arthritis and osteophytes that are the underlying cause.

Treatment Path

how care progresses at OSI

Observation

Small, asymptomatic cysts can be watched; some resolve spontaneously.

Aspiration

Needle decompression provides temporary relief; recurrence is high without excising the underlying osteophyte.

Surgical Options at OSI

if non-operative care isn't enough

Excision is recommended for symptomatic, recurrent, or draining cysts. A draining cyst carries infection risk to the joint.

Overview

Diagnosis

Treatment Path

Observation

Aspiration

Surgical Options at OSI

Providers Who Treat Mucous Cyst

Michael S. Vrana, M.D.

David B. Templin, M.D.

Trent Twitero, M.D.

Further Reading

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