Peripulley ganglion cyst (A1 pulley)
Complaining of left 3rd metacarpophalangeal joint region palmar aspect nodule for last few days. No trauma. Normal free finger movements.
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There is a thin-walled predominantly anechoic cyst (5 x 4 x 3 mm) abutting the A1 pulley at the 3rd metacarpophalangeal joint. There is no vascularity in the lesion. The A1 pulley is intact. There is no tendon thickening/tenosynovitis/flexor tendon tear. Palmar plate is intact. There is no metacarpophalangeal joint effusion. The lesion is free from adjacent neurovascular bundles. Dynamic interrogation shows free tendon movements.
Ultrasound findings favor peri-A1 pulley ganglion cyst. Peripulley ganglion cysts are located on the volar aspect of the finger. Location of A1 pulley ganglion cysts is at the metacarpophalangeal joint level and that of A2 pulley ganglia at the midshaft of the proximal phalanx.