Presentation
A patient presented with a painful nodule involving the palmar surface of the middle finger base for the last few days. There is no history of trauma.
Patient Data
The palpable nodule revealed to be an anechoic, thin-walled avascular cyst (3 x 2 mm), abutting the palmar aspect of the flexor tendon. Acoustic enhancement is present. It overlies mid-shaft of the proximal phalanx. The axial view shows adjacent A2 pulley.
The flexor tendon shows normal echopattern without tenosynovitis. Dynamic scan showed free tendon movement. There is no MCP or IP joint effusion.
Case Discussion
The case shows a digital ganglion cyst adjacent to the A2 pulley. Digital ganglia are less common and smaller than wrist ganglia 1. Even though the cysts are smaller in size, they are more painful.