{"id":4157,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/mucouscyst\/"},"modified":"2025-04-22T16:22:22","modified_gmt":"2025-04-22T15:22:22","slug":"mucouscyst","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/plasticsurgery\/handsurgery\/mucouscyst\/","title":{"rendered":"Mucous Cyst"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">\u200b<strong>Distal interphalangeal joint (DIPJ) ganglion, commonly called a <em>mucous cyst<\/em>, or Dorsal digital ganglion cysts<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Distal Interphalangeal joint ganglion commonly present as lumps on the dorsum of the finger at one or other side of the joint. They can also form at the edge of the proximal nail fold. They are harmless and will frequently resolve on their own.&nbsp;&nbsp;<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter\"><div class=\"wpcp-wp-lightbox-host wpcp-advanced-image-lightbox-icon-hover\"><a class=\"wpcp-wp-lightbox-image-link\" href=\"\/files\/sites\/2\/Mucous-Cyst-fig-1.png\" data-wpcp-wp-lb-image=\"1\"><img decoding=\"async\" src=\"\/files\/sites\/2\/Mucous-Cyst-fig-1.png\" alt=\"Mucous Cyst figure 1\" \/><\/a><figcaption class=\"wp-element-caption\">images courtesy of NHS Lothian<\/figcaption><a href=\"\/files\/sites\/2\/Mucous-Cyst-fig-1.png\" data-fancybox=\"wpcp-wp-wpcp-wp-1\" class=\"wpcp-lightbox-trigger wpcp-advanced-image-lightbox-icon wpcp-position-top-right wpcp-advanced-image-lightbox-icon-hover wpcp-global-lightbox-icon wpcp-lightbox-icon--global wpcp-lb-icon-style-default\" data-wpcp-lb-icon-source=\"global\" aria-label=\"Open image in lightbox\" data-thumb-src=\"\/files\/sites\/2\/Mucous-Cyst-fig-1.png\" data-wpcp-lb-single=\"1\"><span class=\"wpcp-icon-container\"><svg viewBox=\"0 0 20 20\"><path d=\"M17.6585 16.025L14.2437 12.6198C15.1716 11.3338 15.6121 9.7613 15.4871 8.1819C15.362 6.60251 14.6795 5.11847 13.5607 3.99351C12.936 3.36206 12.1916 2.86066 11.3709 2.51845C10.5502 2.17623 9.66952 2 8.77995 2C7.89039 2 7.00969 2.17623 6.18899 2.51845C5.36829 2.86066 4.62395 3.36206 3.99919 3.99351C3.36594 4.61649 2.86312 5.35871 2.51992 6.17708C2.17673 6.99545 2 7.87365 2 8.76068C2 9.64772 2.17673 10.5259 2.51992 11.3443C2.86312 12.1627 3.36594 12.9049 3.99919 13.5279C5.11957 14.6901 6.62279 15.4103 8.23285 15.5562C9.84291 15.7022 11.4517 15.2641 12.7639 14.3224L16.1788 17.7275C16.3849 17.9034 16.6473 18 16.9186 18C17.1899 18 17.4523 17.9034 17.6585 17.7275C18.1138 17.16 18.1138 16.5925 17.6585 16.025ZM5.59278 12.0523C5.16258 11.6298 4.82094 11.1263 4.58774 10.5709C4.35455 10.0156 4.23446 9.41951 4.23446 8.81744C4.23446 8.21536 4.35455 7.6193 4.58774 7.06394C4.82094 6.50859 5.16258 6.00503 5.59278 5.58257C6.01644 5.15359 6.52144 4.81292 7.07838 4.58039C7.63532 4.34786 8.23308 4.22811 8.83687 4.22811C9.44066 4.22811 10.0384 4.34786 10.5954 4.58039C11.1523 4.81292 11.6573 5.15359 12.081 5.58257C12.5112 6.00503 12.8528 6.50859 13.086 7.06394C13.3192 7.6193 13.4393 8.21536 13.4393 8.81744C13.4393 9.41951 13.3192 10.0156 13.086 10.5709C12.8528 11.1263 12.5112 11.6298 12.081 12.0523C11.6573 12.4813 11.1523 12.822 10.5954 13.0545C10.0384 13.287 9.44066 13.4068 8.83687 13.4068C8.23308 13.4068 7.63532 13.287 7.07838 13.0545C6.52144 12.822 6.01644 12.4813 5.59278 12.0523Z\" \/><\/svg><\/span><\/a><\/div><\/figure>\n<\/div>\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter\"><div class=\"wpcp-wp-lightbox-host wpcp-advanced-image-lightbox-icon-hover\"><a class=\"wpcp-wp-lightbox-image-link\" href=\"\/files\/sites\/2\/Mucous-Cyst-fig-2.png\" data-wpcp-wp-lb-image=\"1\"><img decoding=\"async\" src=\"\/files\/sites\/2\/Mucous-Cyst-fig-2.png\" alt=\"Mucous Cyst figure 2\" \/><\/a><figcaption class=\"wp-element-caption\">images courtesy of NHS Lothian<\/figcaption><a href=\"\/files\/sites\/2\/Mucous-Cyst-fig-2.png\" data-fancybox=\"wpcp-wp-wpcp-wp-2\" class=\"wpcp-lightbox-trigger wpcp-advanced-image-lightbox-icon wpcp-position-top-right wpcp-advanced-image-lightbox-icon-hover wpcp-global-lightbox-icon wpcp-lightbox-icon--global wpcp-lb-icon-style-default\" data-wpcp-lb-icon-source=\"global\" aria-label=\"Open image in lightbox\" data-thumb-src=\"\/files\/sites\/2\/Mucous-Cyst-fig-2.png\" data-wpcp-lb-single=\"1\"><span class=\"wpcp-icon-container\"><svg viewBox=\"0 0 20 20\"><path d=\"M17.6585 16.025L14.2437 12.6198C15.1716 11.3338 15.6121 9.7613 15.4871 8.1819C15.362 6.60251 14.6795 5.11847 13.5607 3.99351C12.936 3.36206 12.1916 2.86066 11.3709 2.51845C10.5502 2.17623 9.66952 2 8.77995 2C7.89039 2 7.00969 2.17623 6.18899 2.51845C5.36829 2.86066 4.62395 3.36206 3.99919 3.99351C3.36594 4.61649 2.86312 5.35871 2.51992 6.17708C2.17673 6.99545 2 7.87365 2 8.76068C2 9.64772 2.17673 10.5259 2.51992 11.3443C2.86312 12.1627 3.36594 12.9049 3.99919 13.5279C5.11957 14.6901 6.62279 15.4103 8.23285 15.5562C9.84291 15.7022 11.4517 15.2641 12.7639 14.3224L16.1788 17.7275C16.3849 17.9034 16.6473 18 16.9186 18C17.1899 18 17.4523 17.9034 17.6585 17.7275C18.1138 17.16 18.1138 16.5925 17.6585 16.025ZM5.59278 12.0523C5.16258 11.6298 4.82094 11.1263 4.58774 10.5709C4.35455 10.0156 4.23446 9.41951 4.23446 8.81744C4.23446 8.21536 4.35455 7.6193 4.58774 7.06394C4.82094 6.50859 5.16258 6.00503 5.59278 5.58257C6.01644 5.15359 6.52144 4.81292 7.07838 4.58039C7.63532 4.34786 8.23308 4.22811 8.83687 4.22811C9.44066 4.22811 10.0384 4.34786 10.5954 4.58039C11.1523 4.81292 11.6573 5.15359 12.081 5.58257C12.5112 6.00503 12.8528 6.50859 13.086 7.06394C13.3192 7.6193 13.4393 8.21536 13.4393 8.81744C13.4393 9.41951 13.3192 10.0156 13.086 10.5709C12.8528 11.1263 12.5112 11.6298 12.081 12.0523C11.6573 12.4813 11.1523 12.822 10.5954 13.0545C10.0384 13.287 9.44066 13.4068 8.83687 13.4068C8.23308 13.4068 7.63532 13.287 7.07838 13.0545C6.52144 12.822 6.01644 12.4813 5.59278 12.0523Z\" \/><\/svg><\/span><\/a><\/div><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\">They tend to occur in older people and are usually associated with underlying joint degeneration (osteoarthritis of DIP joint).&nbsp;&nbsp;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>The lump can fluctuant in size.&nbsp;&nbsp;<\/li>\n\n\n\n<li>If they grow at the proximal nail fold, they can cause a nail deformity (groove or nail split) due to pressure on the germinal matrix.&nbsp;<\/li>\n\n\n\n<li>They can be painful, but it can be difficult to tell if the pain is coming from the lump or the underlying osteoarthritis.&nbsp;<\/li>\n\n\n\n<li>The mucous cysts can burst. The skin overlying can be thin and translucent. These factors can allow infection to develop and track deep into the joint.&nbsp;<\/li>\n\n\n\n<li>We do not recommend aspiration or bursting of mucous cysts, as this can lead to septic arthritis.&nbsp;<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Surgical excision may be indicated for mucous cysts with thin skin or history of bursting, or those that cause a nail deformity.&nbsp;<\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"wp-block-paragraph\"><strong><em>Please see the<a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Mucous-cysts-Patient-Information-Leaflet.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"> patient information sheet <\/a>(see primary care management tab) and print off and give to the patient.<\/em><\/strong>\u00a0<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">It is usually best to leave the cyst alone unless it is causing significant symptoms. Any treatment of the cyst carries a risk that may leave the patient worse off.&nbsp;<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Who to refer:<\/strong><strong><\/strong><\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Mucous cysts that have burst recurrently and are at risk of developing deep infection (septic arthritis)&nbsp;<\/li>\n\n\n\n<li>Mucous cysts causing significant symptoms in patient who have tried first line treatment options, and are willing to take the risks associated with surgery&nbsp;(<em>see<strong> PRIMARY CARE MANAGEMENT SECTION<\/strong>)<\/em><\/li>\n\n\n\n<li>Please include a photograph of the patients lump&nbsp;<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Who not to refer:<\/strong><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Patients who have not undergone first line treatment with minor or cosmetic symptoms&nbsp;(<em>see<strong> PRIMARY CARE MANAGEMENT SECTION<\/strong>)<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Direct referral to the hand service<\/strong>&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Please include a <strong>photograph <\/strong>of the patient\u2019s cyst\/lump&nbsp;&nbsp;<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Mucous-cysts-Patient-Information-Leaflet.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Patient information leaflet\u00a0<\/a>\u2013 see separate document<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Trial of first line treatment<\/strong>&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><u>We suggest at least a 3 month trial of first line treatment before considering referral for most mucous cysts<\/u><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If the mucous cyst is small, not painful, and not affecting the movement of the finger, we recommend trying some simple, non-surgical treatments. Here are a few ways patients can manage it without surgery:&nbsp;<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li><strong>Warm Compresses<\/strong>&nbsp;<br>Placing a warm, damp washcloth over the cyst for a few minutes a couple of times a day may help relieve any discomfort and keep the area flexible.&nbsp;<\/li>\n\n\n\n<li><strong>Finger Splinting<\/strong>&nbsp;<br>If your finger is sore, a splint can help keep it still and reduce pain. This is helpful if the cyst is inflamed (swollen and tender). You can buy a splint online for &lt;\u00a310 or use a lolly stick with tape to keep the finger still overnight.&nbsp;<\/li>\n\n\n\n<li><strong>Anti-inflammatory Gels<\/strong>&nbsp;<br>If the cyst is painful, you can use an anti-inflammatory gel, like ibuprofen or Voltarol gel, to help reduce swelling and pain.&nbsp;&nbsp;<\/li>\n\n\n\n<li><strong>Keeping the Area Clean<\/strong>&nbsp;<br>Since mucous cysts can occasionally pop on their own, it\u2019s important to keep the area clean to avoid infection. If the cyst does open, cover it with a clean bandage&nbsp;<\/li>\n<\/ol>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Never try to pop the cyst on purpose, as this can lead to infection or make the cyst worse.<\/em>&nbsp;<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/lothianvirtualhandclinic.co.uk\/mucous-cysts\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/lothianvirtualhandclinic.co.uk\/mucous-cysts\/<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.bssh.ac.uk\/patients\/conditions\/20\/ganglion_cysts\" target=\"_blank\" rel=\"noreferrer noopener\">Ganglion cysts | The British Society for Surgery of the Hand<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.nhsinform.scot\/illnesses-and-conditions\/muscle-bone-and-joints\/arm-shoulder-and-hand-problems-and-conditions\/ganglion-cyst\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.nhsinform.scot\/illnesses-and-conditions\/muscle-bone-and-joints\/arm-shoulder-and-hand-problems-and-conditions\/ganglion-cyst\/<\/a><\/p>\n<\/div><\/div>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>&#8203;Distal interphalangeal joint (DIPJ) ganglion, commonly called a mucous cyst, or Dorsal digital ganglion cysts Distal Interphalangeal joint ganglion commonly present as lumps on the dorsum of the finger at one or other side of the joint. They can also form at the edge of the proximal nail fold. They are harmless and will frequently<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3988,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[558],"class_list":["post-4157","page","type-page","status-publish","hentry","category-mucous-cyst"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/plasticsurgery\/handsurgery\/mucous-cyst\/\" rel=\"tag\">Mucous Cyst<\/a>","rttpg_excerpt":"&#8203;Distal interphalangeal joint (DIPJ) ganglion, commonly called a mucous cyst, or Dorsal digital ganglion cysts Distal Interphalangeal joint ganglion commonly present as lumps on the dorsum of the finger at one or other side of the joint. They can also form at the edge of the proximal nail fold. They are harmless and will frequently","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4157","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4157"}],"version-history":[{"count":0,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4157\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3988"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4157"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4157"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}