Post traumatic ganglion cyst

Case contributed by Dr Mahmoud Yacout Alabd

Presentation

History of road traffic accident with trauma to the wrist joint followed by chronic pain.

Patient Data

Age: 28
Gender: Male
Modality: X-ray

A fracture at the base of the ulnar styloid. 

Modality: CT

Irregularity, sclerotic changes and abnormal alignment of the ulnar styloid, suggesting old fracture with secondary degenerative changes. 

Modality: MRI

Edema of the bone marrow at the base of the ulnar styloid (appreciated on coronal PD fat sat) with interruption and irregularity of the cortex (best appreciated on coronal T2). There is a fluid containing structure just superior to the ulnar styloid having a narrow tail connected to the the ulno-carpal joint (best appreciated on axial T2 sequence). Abnormal signal intensity is also seen at the triangular fibrocartilage suggesting ligamentous injury. There is also mild effusion  at the ulno-metacarpal joint.

Conclusion: Old fracture of the ulnar styloid with secondary degenerative changes, ganglion cyst and possible ligamentous injury to the triangular fibro-cartilage. 

Case Discussion

Old fracture of the ulnar styloid with secondary degenerative changes, ganglion cyst and possible ligamentous injury to the triangular fibrocartilage, findings include:

  • Edema of the bone marrow at the base of the ulnar styloid (appreciated on coronal PD fat sat) with interruption and irregularity of the cortex (best appreciated on coronal T2).
  • There is a fluid containing structure just superior to the ulnar styloid having a narrow tail connected to the the ulno-carpal joint (best appreciated on axial T2 sequence).
  • Abnormal signal intensity is also seen at the triangular fibrocartilage suggesting ligamentous injury.
  • There is also mild effusion at the ulno-metacarpal joint. 

Typical appearance of a ganglion cyst: thin walled, fluid filled, benign in nature and having a definite connection to a joint. Ganglion cyst can be idiopathic or secondary to trauma as in this case. 

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Case Information

rID: 40457
Case created: 22nd Oct 2015
Last edited: 25th Oct 2015
Inclusion in quiz mode: Included

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