Is Generalized Joint Hypermobility a Risk Factor in the Development of Wrist Ganglion Cysts? A Retrospective Case-Control Study

Abstract

Purpose The aim of this study was to evaluate the association between ganglion cysts and generalized joint hypermobility and to identify potential independent risk factors. Methods In this retrospective case-control study, a total of 972 participants were included, comprising 243 patients diagnosed with ganglion cysts and 729 controls. Demographic characteristics, body mass index, occupational category, regular physical activity, and Beighton scores were recorded. Generalized joint hypermobility was defined as a Beighton score ?4. Risk factors were analyzed using univariate and multivariate logistic regression models. Results There were no significant differences between the groups in terms of age (P = .185), sex (P = .629), body mass index (P = .412), or regular physical activity (P = .423). The proportion of individuals engaged in manual occupations was significantly higher in the ganglion cyst group compared to controls (P = .005). The mean Beighton score was significantly greater in patients with ganglion cysts and the prevalence of hypermobility was 64% in the ganglion group compared with 19% in controls. In multivariate analysis, hypermobility (adjusted OR, 7.1; 95% CI: 5.1–9.9) and manual occupation (adjusted OR, 1.4; 95% CI: 1.0–1.9) were identified as independent risk factors. A significant positive trend was observed across Beighton score categories. Conclusions Generalized joint hypermobility seems to be a strong and independent risk factor for the development of ganglion cysts. The risk increases substantially with greater severity of hypermobility. These findings suggest that intrinsic connective tissue characteristics may play a key role in the pathogenesis of ganglion cysts. Type of study Aetiology (risk factors), case-control study. Level of Evidence Level III. © 2026 American Society for Surgery of the Hand.