Mucous cyst

A mucous cyst is a type of ganglion.  It arises at the DIP joint.  This is the joint at the end of the finger, nearest the nail.

These cysts are not dangerous, but some patients find them unsightly.  They can also be painful.  Frequently they go through a cycle of swelling up and becoming painful before bursting spontaneously and then resolving for a while before flaring up again.

A mucous cyst on a finger

Mucous cysts are usually associated with some degree of osteoarthritis in the DIP joint, but this is not inevitable.  Sometimes they cause some deformity of the nail.

Diagnosis and investigations
The diagnosis is usually easy to make, although sometimes arthritic lumps on the finger (Heberden's nodes) may look similar.  Sometimes we suggest obtaining an xray of the joint.

Given that this is a benign condition no treatment is necessary.  

If you wish treatment aspiration and injection are unlikely to help and we recommend surgery.

What is involved in surgery?
The surgery aims to excise the capsule, or lining of the joint and sometimes remove some of the bony lumps (osteophytes).  The operation involves a scar on the back of the finger.  Care must be taken not to damage the tendon that straightens the finger or the collateral ligaments that stabilise either side of the joint.

The surgery is performed as a day case under local or general anaesthetic.

There would be stitches in the wound for 12 to 14 days.

Are there any risks in surgery?
All surgery has a degree of risk attached to it.  This surgery is no different, but the risks are small in numerical terms,.  They include a risk of infection, of recurrence, of abnormal and prolonged pain response and of injury to the structures discussed above.  After the operation the wound is often lumpy for a while but will settle over a period of weeks.

How long would I be off work after surgery?
For clerical work one might anticipate 2 to 4 weeks off.  For manual work up to 6 weeks off work.