How can I differentiate between a ganglion cyst and other soft tissue masses during a clinical examination?

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 ¹.

Palpate the mass to determine its consistency, assessing if it is soft, firm, or fluctuant ¹.

Assess the mass's mobility, checking if it is fixed or mobile relative to underlying structures ¹.

Check for tenderness on palpation ¹.

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 ¹.

It is also important to check for pulsatility or a bruit, which would suggest a vascular lesion rather than a cyst ¹.

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 ².

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).