Volar Retinacular Cysts

As Dr. Donnelly recently discussed in his blog post Cysts, Lumps & Bumps!, finding unfamiliar bumps on our hands, arms, or elbows can be alarming. Fortunately, most of these types of lumps are totally harmless.

In today’s blog post, Dr. Donnelly discusses volar retinacular cysts - small growths that can sometimes cause real problems.

There are many different types of cyst that can appear all over the body. “Cysts” are small sacs of fluid or gas that can develop just under the skin. “Retinacular cysts” are very small cysts that affect the sheaths around a tendon, called the retinaculum. They are a type of “ganglion cyst,” meaning that they are filled with jelly-like joint fluid. The term “volar” refers to conditions involving the palm of the hand or the sole of the foot. So, volar retinacular cysts are cysts that form around the tendons in the palm of your hand or fingers. 

These cysts are usually about the size of a BB gun pellet, or a small green pea. Despite their small size, they can still cause significant pain if they are located in an unfortunate place. Retinacular cysts located in a joint or a frequently-used tendon can feel painful when the hand is in use, such as when gripping an object. This is because movement can cause the cyst to put pressure on the surrounding tissues and nerves.

Unfortunately, it’s unclear what causes this type of fluid-filled cyst to develop. Sometimes, a retinacular cyst will form on a joint or tendon in an area where the tissue is bulging out of place. Other times, they form in joints that have become weakened or herniated. Volar retinacular cysts seem to most often occur in patients who suffer from flexor tendonitis or trigger fingers.  A different kind of cyst, called a mucous cyst is more commonly related to arthritis.

Thankfully, volar retinacular cysts are usually benign and do not need to be treated if they are not causing pain. However, if a cyst does become painful, it may be drained (or “aspirated”) in our clinic using a small needle and a local anesthetic. 

If aspiration doesn’t fix the painful cyst, it may also be removed surgically. This is a quick, easy procedure that is usually conducted in an outpatient setting. In this case, the cyst and underlying tendon sheath can be removed while the patient is under local anesthetic or light sedation. Cysts removed through surgery rarely reappear.

Most cysts, including volar retinacular cysts, are harmless. However, if you have a lump, bump, or cyst that’s become painful, begun to grow or change appearance rapidly, or caused changes in the skin, call Dr. Brandon Donnelly today to schedule an evaluation.

Dr. Brandon P. Donnelly is a board certified orthopedic surgeon with Pontchartrain Orthopedics & Sports Medicine.  Dr. Donnelly completed his hand and microsurgery fellowship at the prestigious Philadelphia Hand to Shoulder Center. Dr. Donnelly treats all ages of patients in the greater New Orleans area for hand, wrist, and elbow conditions. 

This site is not intended to and does not provide medical advice, professional diagnosis, opinion, treatment or services to you or to any other individual. Through this website and links to other websites, Brandon P. Donnelly, MD provides general information for educational purposes only. The content provided in this website and links, is not a substitute for medical care or treatment. You should not use this information in place of a consultation or the advice of your healthcare provider. Brandon P. Donnelly, MD is not liable or responsible for any advice, course of treatment, diagnosis or any other information, services or product you obtain through this site.