Mucous Cyst M19.049 727.41

synonyms:mucoid cysts, synovial cysts, myxoid cysts, myxomatous cutaneous cysts

Mucous Cyst ICD-10

• M19.041 - Primary osteoarthritis, right hand
• M19.042 - Primary osteoarthritis, left hand
• M19.049 - Primary osteoarthritis, unspecified hand
• S61.229A - Laceration with foreign body of unspecified finger without damage to nail, initial encounter
• S61.229D - Laceration with foreign body of unspecified finger without damage to nail, subsequent encounter
• S61.229S - Laceration with foreign body of unspecified finger without damage to nail, sequela

Mucous Cyst ICD-9

• 727.41 Ganglion of joint
• 715.14 Loc prim osteoarthritis; hand
• 883.1 Open wound of finger, complicated (883.1)

Mucous Cyst Etiology / Epidemiology / Natural History

• Usually 5^th-7^thdecade
• Female > male
• Most are associated with DIP joint arthritis and may have a pedicle from the DIP joint.

Mucous Cyst Anatomy

Mucous Cyst Clinical Evaluation

• Fluid filled cyst and thin skin over the DIP joint of a finger.
• May have chronic drainage or infection
• The cyst itself, or the underlying arthritis in the DIP joint may be painful.  
• May cause longitudinal grooving of the nail due to pressure on nail matrix

Mucous Cyst Xray / Diagnositc Tests

• AP and lateral views of the affected digit: generally demonstrate DIP arthritis with dorsal osteophyte.
  

Mucous Cyst Classification / Treatment

• Mucous Cyst excision as well as osteophytes.  Avoid injury to extensor tendon, nail matrix, articular surface, often requires rotation flap or full thickness skin graft for closure.
• CPT: 26160 Excision of lesion of tendon sheath or capsule; cyst, mucous cyst, or ganglion, hand or finger
• Post-op care=cast or splint for 2wks if skin graft used.  Early motion otherwise

Mucous Cyst Associated Injuries / Differential Diagnosis

• epidermoid inclusion cyst
• Heberden nodes
• rheumatoid nodules
• xanthoma
• giant cell tumor of the tendon sheath
• gout.

Mucous Cyst Complications

Mucous Cyst Follow-up Care

• Post-op: place in extension splint, STAXX splint if extensor tendon repair required or skin graft used.   Early motion otherwise
• 7-10 Days: wound check.  Staxx splint if extensor tendon repair, early ROM otherwise.

Review References

• Thornburg LE. Ganglions of the hand and wrist. JAAOS. 1999;7:231-8. 
• Budoff JE. Mucous Cysts. J Hand Surg Am 2010;35:828
• Kasdan ML, Stallings SP, Leis VM. Outcome of surgically treated mucous cysts of the hand. J Hand Surg Am 1994;19:504.
• Shin EK, Jupiter JB. Flap advancement coverage after excision of large mucous cysts. Tech Hand Up Extrem Surg. 2007;11:159.
• °