Lumps and Bumps Common to the Hand

Bump on your hand? Before you get too worried, know that most bumps in the hand are benign. Below is a brief review of the most common hand “bumps,” followed by reasons to seek surgical expertise.

Ganglion cyst

This is the most common mass in the hand. It is a benign “mass,” and is typically associated with an area of increased inflammation, be it a tendon sheath or joint. They are often 1-2cm in size, are soft, and typically not painful. Often, these arise in the front or the back of the wrist. They may be associated with underlying arthritis, and in those cases often “grow” as an outpouching of the joint capsule. They may also be seen in the fingers as they can “balloon” off of the tendon sheath or small joints in the fingers. What’s important to know is that these cysts should not be popped, specifically because they are filled with fluid that can become infected. They occasionally go away with time. If they persist and are bothersome, they may be removed in a simple outpatient surgery.

Giant-cell tumor

Tumor” may be a scary word, but in this case it simply refers to “mass,” as these are not a malignant cancer. These masses are typically 1-2 cm, grow slowly, and are typically found in the fingers. They are usually not painful and may be removed as an outpatient surgery if they are bothersome to patients.

Mucous cyst

These bumps are similar to a ganglion cyst, but specifically arise over the last knuckle of the finger, just next the area where the fingernail begins to grow. These cysts are filled with joint fluid and are typically associated with underlying arthritis. They are typically less than 1cm and are rarely painful. A large bone spur coming from the joint can be the reason for the cyst. Sometimes, they can cause changes in the fingernail as well. These bumps should never be popped, as that can lead to an infection. These may grow smaller or larger, and if they grow larger, can be removed with outpatient surgery.

Epidermal inclusion cyst

These small bumps may be related to a previous cut in the finger or other trauma to the hand. They form when some of the epidermis (the outer layer of skin) becomes lodged deeper than it should be, and forms keratin-like tissue just below the skin. They can grow larger and can become infected; if this occurs they can also be removed with relatively simple surgery.

While these are the most common masses seen in most hand practices, there are a variety of other lumps and bumps seen in the hand. If a bump seems to be growing quickly, or becomes painful, the best thing is to seek a specialist’s opinion to be sure that there is nothing worrisome about the bump. Radiographs may be used to help make the diagnosis. Rarely, an MRI is ordered to better evaluate the bump. The most critical part to a diagnosis is a thorough exam with an experienced hand specialist.