Digital flexor tendon sheath ganglions

Case contributed by Dr Roberto Schubert


Firm, moderately tender masses at the 3rd and 5th finger. Normal appearing skin.

Patient Data

Age: 60
Gender: Female

Smoothly marginated lesions at the proximal phalanges III (mediallly) and V (laterally) with fluid equivalent signal, each adjacent to the respective flexor sheaths.

Case Discussion

Ganglion cysts of the finger flexor tendons occur more often in women (2.6:1). The middle finger is most commonly affected. The are located at the A1 and A3 pulleys in 69% of cases1. This is why they are also referred to as annular ligament cysts. On ultrasound, more than half show complex echogenicity2.

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