During a clinical examination, differentiating a ganglion cyst from other soft tissue masses involves a systematic assessment of the lump's characteristics.
A ganglion cyst is a common type of soft tissue mass, frequently found at the wrist Nguyen et al. 2004.
When examining any soft tissue mass, it is important to note its location, size, shape, and any associated skin changes NICE CKS.
Palpate the mass to determine its consistency, assessing if it is soft, firm, or fluctuant NICE CKS.
Assess the mass's mobility, checking if it is fixed or mobile relative to underlying structures NICE CKS.
Check for tenderness on palpation NICE CKS.
A key test for differentiating a fluid-filled cyst, such as a ganglion cyst, from a solid mass is transillumination; a cyst may appear translucent when a light is shone through it NICE CKS.
It is also important to check for pulsatility or a bruit, which would suggest a vascular lesion rather than a cyst NICE CKS.
If a soft tissue mass exhibits features such as rapid growth, fixation to underlying structures, irregular shape, or is associated with unexplained pain or systemic symptoms, these are red flags that warrant urgent referral for further investigation to exclude malignancy NICE NG12.
While clinical examination provides strong indicators, imaging, such as ultrasound, is often used to confirm the diagnosis of a ganglion cyst and differentiate it from other masses, particularly when the clinical diagnosis is uncertain Nguyen et al. 2004.