Swelling on Wrists
Swelling on wrist on midline on dorsum
Soft and cystic swelling are suggestive of Ganglion cyst.
2/3rd arise from Radiocarpal joint.
1/3rd arise from Scaphotrapezoidal joint.
Histological Definition
fluid filled cavity lined by compressed collagen and a few cells.
Clinical Tests
Compressible
Transilluminate
Investigation
Ultrasound
MRI
Biopsy
General Sites
volar side of wrist ( RS joint)
dorsal side of wrist (SL Lig.)
DIP Joints of digits- present as dorsal distal ganglion or mucoid cyst
A2 Pulley region in relation to flexor tendon sheath.
Intraosseous Ganglion - uncommon ,often in lunate.
Treatment
Simple Observation
Outpatient Procedure - Simple aspiration under Local Anaesthesia
Risks- haematoma, infection,radial artery damage,recurrence
Surgical Excision (Open or Arthroscopic )
Risks - anaesthetic and
surgical - nerve/vessel damage
tendon injury
haematoma
infection
pain/swelling/tenderness/stiffness
recurrence
Risk of recurrence are same for all three treatment methods.
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