synonyms:mucoid cysts, synovial cysts, myxoid cysts, myxomatous cutaneous cysts
Mucous Cyst ICD-10
Mucous Cyst ICD-9
- 727.41 Ganglion of joint
- 715.14 Loc prim osteoarthritis; hand
- 883.1 Open wound of finger, complicated (883.1)
Mucous Cyst Etiology / Epidemiology / Natural History
- Usually 5th-7thdecade
- Female > male
- Most are associated with DIP joint arthritis and may have a pedicle from the DIP joint.
Mucous Cyst Anatomy
Mucous Cyst Clinical Evaluation
- Fluid filled cyst and thin skin over the DIP joint of a finger.
- May have chronic drainage or infection
- The cyst itself, or the underlying arthritis in the DIP joint may be painful.
- May cause longitudinal grooving of the nail due to pressure on nail matrix
Mucous Cyst Xray / Diagnositc Tests
- AP and lateral views of the affected digit: generally demonstrate DIP arthritis with dorsal osteophyte.
Mucous Cyst Classification / Treatment
- Mucous Cyst excision as well as osteophytes. Avoid injury to extensor tendon, nail matrix, articular surface, often requires rotation flap or full thickness skin graft for closure.
- CPT: 26160 Excision of lesion of tendon sheath or capsule; cyst, mucous cyst, or ganglion, hand or finger
- Post-op care=cast or splint for 2wks if skin graft used. Early motion otherwise
Mucous Cyst Associated Injuries / Differential Diagnosis
- epidermoid inclusion cyst
- Heberden nodes
- rheumatoid nodules
- giant cell tumor of the tendon sheath
Mucous Cyst Complications
- Extensor tendon rupture / lag
- Incomplete relief of pain
- Painful hardware
- Nail deformity
Mucous Cyst Follow-up Care
- Post-op: place in extension splint, STAXX splint if extensor tendon repair required or skin graft used. Early motion otherwise
- 7-10 Days: wound check. Staxx splint if extensor tendon repair, early ROM otherwise.
- Thornburg LE. Ganglions of the hand and wrist. JAAOS. 1999;7:231-8.
- Budoff JE. Mucous Cysts. J Hand Surg Am 2010;35:828
- Kasdan ML, Stallings SP, Leis VM. Outcome of surgically treated mucous cysts of the hand. J Hand Surg Am 1994;19:504.
- Shin EK, Jupiter JB. Flap advancement coverage after excision of large mucous cysts. Tech Hand Up Extrem Surg. 2007;11:159.