Mucous Cysts

What are mucous cysts?

Small, fluid-filled sacs, mucous cysts can be identified as lumps found on the back of the thumb or finger. Typically appearing at the joint nearest the fingernail (the distal interphalangeal (DIP) joint).

Most mucous cysts will not cause you any pain or cause dysfunction in any way, however, they can become troublesome and, in some instances, cause problems with the fingernail as well as the underlying joint. 

We typically see mucous cysts in patients aged between 50-70. However, they can appear on anyone, at any time, at any age.

Mucous Cysts - cause, treatment, surgery and post-operative care

Why do mucous cysts appear?

Mucous cysts are similar to ganglion cysts that are found in the wrist, in that they appear because of a build-up of fluid.

The synovial fluid primarily cushions and protects the tendons and joints in your fingers and hands. However, sometimes this fluid can also accumulate and form a small sac at the joint.

The fluid is sealed in place by a membrane; however, in some cases, if there is a perforation in the membrane, fluid can seep out, forming a bump (cyst) underneath the skin’s surface.

Our bodies tend to find it difficult to disperse this fluid, as it is quite thick due to the unique proteins contained within.

Cysts can also form as a result of arthritis in the joints or by bone spurs (small bumps on the bone surface) in the affected finger joints (as the joint lining is weakened by the appearance of arthritis).

It’s important to note that the above can be contributing factors to cysts appearing; however, mucous cysts are not necessarily caused by a particular condition or event, and they can affect anyone at any stage of life.

The appearance of mucous cysts

Mucous cysts are typically found at the tip of your finger – the end joint below your fingernail. The cyst itself can cause unwanted pressure in the bed of the nail, causing uneven nail growth or even forming a small groove in the nail itself.

In most cases, mucous cysts aren’t painful or harmful and often do not require any form of treatment, disappearing on their own over time. However, in rare situations, these cysts can become infected, leading to joint infection in the affected finger/thumb.

To prevent infection and further tissue damage, we recommend that you don’t puncture or attempt to remove cysts at home. Instead, we’d recommend having these checked as soon as possible to reduce the chances of further complications and to investigate if there is potentially an underlying problem.

Speak to your GP as soon as possible or contact The Manchester Hand Surgeon to book your initial examination appointment.

Symptoms of Mucous Cysts

  • A small lump may appear on the back of your finger joint, slightly off to one side
  • Your joint will feel stiff when moving
  • The affected joint can feel tender to touch
  • The outline of the cyst will feel quite smooth, with the cyst itself feeling like a balloon or small ball beneath the skin

For the hand specialists at The Manchester Hand Surgeon, the diagnosis of mucous cysts is reasonably straightforward. We will carry out clinical examinations as well as more in-depth x-rays and scans to show the extent of wear and tear and potential damage to the joint, as well as investigating any underlying issues which may be causing the problems to arise.

Treatment

Treatment of mucous cysts does vary from patient to patient, depending on exact symptoms and after a thorough examination.

In most cases, if the cyst is not causing any real discomfort or pain, we will recommend leaving the cyst for a set period, monitoring its size and formation, and allowing enough time for the cyst to disappear on its own.

However, if the cyst is indeed causing problems, we’re on hand to help.

In these instances, we will recommend surgery as the best course of action.

Typically, a day procedure, a local anaesthetic is used, and the procedure will take around 15-20 minutes.

What does surgery involve?

We inject a local anaesthetic into the affected area and joint. Once the finger and the area surrounding the cyst are numb, we will cut into the skin, and lifting the skin flap; we will begin to dissect the cyst. Being careful not to puncture it, we will locate the base of the cyst and remove it in full as well as any nearby arthritic bone.

We will then suture the incision, and a large dressing is applied to protect the wound and hand.

We tailor all treatments to our patients, and the right course of treatment identified for you will be discussed with you after we have carried out all thorough examinations of your cysts and condition.

Post-Operative Care

As the removal of cysts is typically a short surgical procedure, you will be able to return home on the same day.

The anaesthetic will wear off approximately 6 hours after surgery, and over the counter painkillers and pain relief will help with any discomfort and swelling after surgery.

We will advise for the hand to be elevated as much as possible for the first five days after treatment, to help with swelling and inflammation, and we will also provide gentle exercises and stretches to ensure the finger and hand continues to stay mobile.

You will be able to remove the dressing after 2-3 days, and we will recommend the wound be cleaned and redressed with a smaller dressing after this time.

Our team will arrange to follow up appointments with you, 6-8 weeks after the initial surgery, and at a time that is suitable for you.

We advise keeping the wound dry for approximately 7-10 days to help avoid infection and bacteria.

We would recommend waiting 2-3 days after surgery before returning to driving, and only doing so once you feel comfortable and confident that you have full control and strength in your hand.

Every patient is different, every procedure is different, and hence every individual’s recovery time is different. This is especially important when considering returning to work, as this will depend on the type of job you do and the work you carry out.

We would recommend light duties upon your return, and for those involved in labour-intensive work, we’d recommend this period to be between 4-6 weeks to allow for a full recovery.

Further Questions?

If you have any further questions or if you would like any additional information on our hand procedures or cysts in general, please feel free to contact a member of our professional team.

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