Purpose: To assess the morphology, topography, frequency, and etiology of intraosseous carpal ganglions.
Method: Two hundred and eighty formalin fixed cadaveric wrists (mean age 80.3 +/- 9.7 years, range 40 to 101 years) were radiographed. Fifty specimens suspicious for cyst-like bone lesions underwent magnetic resonance imaging (T1w and proton density-fat-saturated images, 1.5T). Dissection, articular surface assessment, and histological examination were performed. Cystic lesions with adjacent destruction of the hyaline cartilage were classified as degenerative and were excluded.
Results: In 27 of the 50 specimens, 48 ganglion cysts (GC) were found. Prevalence of GC was 9.6%. Of 48 intraosseous carpal GC, 41 (85%) were in a peripheral location; 27/48 (56%) were located at the palmar carpus. GC had a macroscopic and microscopic relationship to the insertion of degenerated ligaments. They developed near longitudinally orientated bone surfaces, which serve as insertion for ligaments and are exposed to tension loading.
Conclusions: Unlike degenerative cysts, ganglion cysts do not erode the hyaline articular cartilage and almost always have a continuity with the capsular ligaments. Intraosseous carpal ganglion cysts are probably the result of mucoid degeneration of adjacent ligaments.
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http://dx.doi.org/10.1053/jhsu.2003.50032 | DOI Listing |
Neurosurgery
November 2024
Department of Hand and Foot Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan , China.
Background And Objectives: The unifying articular theory suggests that intraneural ganglion cysts in the cubital tunnel arise from the elbow joint and are connected to the ulnar nerve through an articular branch. This study aimed to report our clinical experience with these cysts and our surgical findings and outcomes.
Methods: We retrospectively analyzed 13 patients who underwent surgery for cubital tunnel syndrome caused by an intraneural ganglion cyst of the ulnar nerve.
Diagn Pathol
December 2024
Department of General Surgery, University of California Los Angeles, Los Angeles , US.
Case: We present the case of a 73-year-old female with an acromioclavicular joint cyst associated with atypical, exquisite, progressive pain, and imaging findings concerning for neoplastic etiology. She underwent en bloc resection of the trapezium containing this cystic mass and distal clavicle. Surgical pathology demonstrated findings consistent with a large ganglion cyst without evidence of malignancy.
View Article and Find Full Text PDFJ Hand Microsurg
December 2024
Division of Plastic Surgery, Department of Surgery, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
Introduction: Ganglion cysts (GCs) are a form of benign soft tissue mass commonly seen on the dorsum of the wrist that could also form in the hand. They can cause pain and impede physical activities. Despite extensive studies, there has not been a thorough analysis of the top 50 GC articles.
View Article and Find Full Text PDFEur J Radiol
December 2024
Radiology, Balgrist University Hospital, Forchstrasse 340, 8008 Zurich, Switzerland; Faculty of Medicine, University of Zurich, Zurich, Switzerland.
Purpose: To evaluate the interest of additional pseudo-CT images to standard clinical contrast-enhanced MR images (CE-MRI) in the detection of inflammatory erosions and to differentiate them from intraosseous ganglia at the finger joints.
Method: 47 prospectively included patients with suspected or diagnosed rheumatoid arthritis received a CE-MRI of the fingers. Additionally, pseudo-CT images were derived from non-contrast MRI (pCT) and from contrast-enhanced MRI data (CE-pCT) using a high-resolution gradient-echo 3D fast low-angle shot sequence (FLASH), respectively.
J Neurosurg Case Lessons
November 2024
Departments of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota.
Background: The articular origin of intraneural ganglion cysts has been previously described and well supported, except for the median nerve at the level of the elbow.
Observations: The authors present a patient with a median intraneural ganglion cyst at the elbow region and magnetic resonance imaging (MRI) evidence of a joint connection to the proximal radioulnar joint. A 63-year-old man presented with thumb flexion weakness and dysesthesias in the thumb, index, and middle fingers.
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