A cystic swelling that occurs on the hands, usually on the dorsal aspect of the wrists.

The cause is not clear, and various possible causes have been proposed. The proposals include: retention cysts; herniation of the tendon; neoplasia; or mucinous degeneration of fibrous tissue.

A swelling in the wrist arises that may be painful either at rest or during movement. Tenderness may only be present when the wrist is palmar flexed. The consistency may be soft or hard, and the size is variable. The cyst is filled with sticky fluid.

Diagnostic measures include physical examination and palpation of the swelling. X-rays are taken to rule out any other causes for the pain and swelling.

Not all ganglions require treatment, as some spontaneously regress. Occasionally, aspiration is done to relieve pain, and then an injection of a corticosteroid is effective as a treatment. Surgical excision is performed when nonsurgical treatment fails.

There are recurrences in 6 to 50% of those persons who had a surgical removal.

• Consider this condition pursuant to 38 CFR 4.27 and 38 CFR 4.20, when applicable. Analogous ratings are utilized when a specific disability is not listed in 38 CFR Part 4. Certain hyphenated codes do not necessarily denote analogous ratings – a hyphenated DC may also be used to identify the proper evaluation of a disability or a residual from disease. Diagnostic Codes (DCs) must be carefully selected as a condition specifically listed in the rating schedule may not be rated by analogy.

• When multiple DCs apply to a given disability, consider whether separate evaluations are warranted, and/or which DC will result in the most advantageous outcome for the claimant. Based on the facts found, the DC most appropriate to the findings and that results in the highest evaluation should be selected.

• None.