Ganglion cysts developed from the flexor tendon sheaths in the fingers: Clinical and sonographic features

Abstract

Purpose: The purpose of this study was to assess the clinical and sonographic features of flexor tendon sheath ganglion cysts in the fingers. Methods:We retrospectively reviewed the clinical and sonographic features of 35 cases of flexor tendon sheath ganglion cysts in the fingers in 34 patients that were pathologically confirmed between 2003 and 2018.Results: The mean age of the patients was 44.2 years (range, 11-73 years). Lesions were located at the level of the metacarpophalangeal joint (n = 22 [63%]) and proximal phalanx (n = 11 [31%]), and involvement of the third finger was common (n = 19[54%]). The mean lesion size was 6 mm and the mean volume was 90 mm 3 . None of the lesions had a pedicle. Lesions were homogeneous (n = 24 [69%]) and anechoic (n = 23 [66%]). A septum was noted in 12 cases (34%). Conclusions:Flexor tendon sheath ganglion cysts are most commonly located in the third finger and at the level of the metacarpophalangeal joint and proximal phalanx. It usually presents as a simple cyst without a pedicle, but occasionally exhibits a mixed echogenicity and contains a septum. K E Y W O R D Sfingers, flexor tendon sheath, ganglion cyst, ultrasonography

Tendons and Tendon Sheaths of the Hand – An Update on MRI

“…Ganglion cysts arising from the synovial sheath of tendons are rare in comparison (tenosynovial ganglion cyst). Common origins are the flexor tendons of the fingers at the level of the annular pulleys [76,77]. On MRI, ganglion cysts usually appear as water-filled and thin-walled cavities that often include septa.…”