Reviewed on : 9 Sep 2021

Reviewed by : Lucy Dyde Coventry & Warwickshire CCG IFR

Expires : 1 Oct 2025

Prior approval from the CCG will be required before any treatment proceeds in secondary care. 

Refer to Secondary Care provider via RSS using the appropriate Prior Approval Referral Form.

Ganglion of Hand or Wrist

**For other types of ganglion please refer to the Treatments for Aesthetic Appearance Policy**

Management of wrist/hand ganglions:

NO treatment unless causing pain or tingling/numbness or concern re diagnosis (worried it is a cancer)

Aspiration if causing pain, tingling/numbness or concern re diagnosis

Surgical excision ONLY considered if aspiration fails to resolve the pain or tingling/numbness and there is restricted hand function.

Referral Criteria

Patients shall be eligible for surgery if the following criteria is met in either Section a, b or c

1. Please confirm that the patient meets the criteria for ONE of the following:

Section a

The patient has SEED GANGLIA that are painful, persistent and/or have re-occurred after puncture/aspiration of the ganglion using a hypodermic needle has failed to resolve the symptoms and there is restricted hand function

Section b

The patient has MUCOUS CYSTS with recurrent spontaneous discharge of fluid or significant nail deformity:

Section c

The patient has WRIST GANGLIA and aspiration has failed to resolve the pain or tingling/numbness and there is restricted hand function