Presentation
Swelling at the dorsal aspect of the wrist for some time, now at the time of the appointment gone.
Patient Data
Findings
flat lobulated cystic lesion (~18 x 15 x 5 mm) dorsal to the proximal and distal carpal row, beneath the extensor digitorum tendons and extensor carpi radialis brevis tendon
no central but strong peripheral enhancement
mild amount of fluid around the extensor pollicis longus tendon
remaining extensor and flexor tendons unremarkable
Impression
-
dorsal wrist ganglion beneath the extensor digitorum tendon
Exam courtesy: Stefan Baumbach (radiographer)
Case Discussion
Ganglion cysts are frequent mass-like lesions of the wrist, that tend to grow with activity and shrink with rest. A typical location is at the dorsum of the wrist underneath the extensor digitorum tendons with the dorsal capsule and the scapholunate ligament as the site of origin, as in this case.
Ganglion cysts of the hand and wrist do not necessarily require treatment. Management vastly depends on clinical symptoms and patients' demands and includes watchful waiting, aspiration and arthroscopic or surgical excision 1.
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