Ultrasonographic evaluation of wrist ganglia

Bianchi, Stefano; Abdelwahab, Ibrahim Fikry; Zwass, Alicia; Giacomello, Patricio

doi:10.1007/bf00197461

Cited by 72 publications

(42 citation statements)

References 18 publications

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“…Rohrich et al [16] mentioned that there were three predominant theories about the origin of a ganglion: 1) they arise as an outpouching or weakening of the joint capsule, 2) they arise from a mesothelial embryonic rest, and 3) they arise due to mucin formation by fibroblasts of the joint space or bursa. In an extensive review of the literature, we found that ganglion cysts occur most frequently in juxta-articular locations such as hand and wrist [17,18]. However, intramuscular ganglion cysts are uncommon, with only a few reported cases [3-14, 16, 19-25], of which, intramuscular ganglion cysts located in the proximal calf are even rarer with fewer case reports [3-14, 19, 24, 25].…”

Section: Discussionmentioning

confidence: 99%

Intramuscular Cysts at the Proximal Calf: Two Case Reports and a Systematic Review of Literature

et al. 2018

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Intramuscular cysts at the proximal calf are rare; however, their etiology is diverse, making accurate diagnosis and treatment difficult. To our knowledge, there are no previous publications in literature about intramuscular cysts at the proximal calf, arising from different origins. This article describes two rare cases with intramuscular cysts. Case 1 was diagnosed as an intramuscular ganglion cyst arising from the proximal gastrocnemius medialis muscle, and arthroscopic examination as well as open cyst excision was performed. Case 2 was another type, which has never been reported in the literature. It was diagnosed as diffuse pigmented villonodular synovitis (PVNS), with the intramuscular cyst arising from PVNS, and only arthroscopic synovectomy was performed. The diagnoses for these cases were confirmed by histopathology. In addition, we have summarized intramuscular cysts at the proximal calf by a systematic literature review and divided them into five types based on their origin. The five types are, intramuscular cysts arising from the muscular tissue, knee joint, proximal tibiofibular joint, the neurilemma and PVNS. The treatment of intramuscular cysts varies based on their origin; hence, it is important to identify the origin.

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Section: Discussionmentioning

confidence: 99%

Intramuscular Cysts at the Proximal Calf: Two Case Reports and a Systematic Review of Literature

et al. 2018

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“…With regard to posterior acoustic enhancement, ganglion cysts with posterior acoustic enhancement had a mean volume of 2707 mm 3 and a mean largest dimension of 20.4 mm, whereas those cysts without acoustic enhancement had a mean volume of 198 mm 3 and a mean largest dimension of 8 mm. There was a significant difference in cyst size (volume, P < .0001; largest dimension, P = .018) for those with and without posterior acoustic enhancement; larger cysts showed posterior acoustic enhancement (Figures 3 and 7).…”

Section: Sonographic Characteristicsmentioning

confidence: 98%

“…2 With regard to ganglion cysts of the wrist, their sonographic appearance has predominantly been described as anechoic, oval, round, or lobulated. [3][4][5] Noncompressibility and possible joint extension are other sonographic features of ganglion cysts of the wrist. 1,4 Ganglion cysts of the ankle have also been described as predominantly anechoic, with consistent posterior acoustic enhancement.…”

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confidence: 99%

Sonography of Wrist Ganglion Cysts

Wang

Jacobson

Feng

et al. 2007

Journal of Ultrasound in Medicine

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Objective. In our clinical practice, we have noted wrist ganglion cysts that do not fulfill the criteria for simple cysts. This study retrospectively evaluated the sonographic features of wrist ganglia. Methods. After Institutional Review Board approval, medical records from 1993 through 2003 were searched using International Classification of Diseases, Ninth Revision codes and key words, and sonography log books from 2000 through 2004 were reviewed, which identified 20 wrist ganglion cysts in 16 patients that were proven at surgery or aspiration. A retrospective review of sonographic images was carried out by 2 musculoskeletal radiologists by consensus. Images were evaluated for cyst location, volume, largest dimension, joint or tendon extension, echogenicity, septations, internal echogenicity, posterior acoustic enhancement, margins, lobularity, and vascularity. Results. Of the 20 wrist ganglia, 15 were volar (10 between the flexor carpi radialis and the radial artery), and 5 were dorsal (2 over the scapholunate ligament). The mean volume was 2081 mm 3 (range, 90-15,000 mm 3 ), and the mean largest dimension was 17.3 mm (range, 7-30 mm). Seven volar ganglia showed joint communication. Ten ganglia were anechoic; 7 were hypoechoic; and 3 had anechoic and hypoechoic areas. Eight had septations; 8 had internal echogenic areas; 15 had posterior acoustic enhancement; 13 had well-defined margins; 12 were lobular; and none were vascular. Cysts that were anechoic (P < .0001) or with posterior acoustic enhancement (P = .04) were significantly larger than those that were hypoechoic or without posterior acoustic enhancement. Conclusions. Small wrist ganglion cysts (≤10 mm in the mean largest dimension) often appear hypoechoic without posterior acoustic enhancement and do not fulfill the criteria for a simple cyst.

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“…In addition to the diagnosis of wrist and hand ganglia, sonography is helpful when needle aspiration is warranted [5,12]. Sonography can guide correct placement of the needle tip at the center of the cyst.…”

Section: Bianchi Et Almentioning

confidence: 99%

“…A less common location is the radial aspect of the volar face of the wrist, close to the radial artery, and the palmar aspect of the fingers, near the A1 pulleys. Ganglia on sonography usually appear as hypoechoic or anechoic, well-delineated masses that can show internal septa and are usually located near a joint or a tendon sheath [1,2,[4][5][6][7] (Fig. 1).…”

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confidence: 99%

Sonography of Masses of the Wrist and Hand

Bianchi

Santa

Glauser³

et al. 2008

American Journal of Roentgenology

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capsule of the wrist (60-70%) near the dorsal band of the scapholunate ligament. A less common location is the radial aspect of the volar face of the wrist, close to the radial artery, and the palmar aspect of the fingers, near the A1 pulleys. Ganglia on sonography usually appear as hypoechoic or anechoic, well-delineated masses that can show internal septa and are usually located near a joint or a tendon sheath [1,2,[4][5][6][7] (Fig. 1).The sonographic appearance of ganglia depends on their size and chronicity [6]. Larger cysts are often anechoic, and old lesions are echogenic and show internal thick septa. Color Doppler sonography can show a hypervascular wall in symptomatic patients (Fig. 2), although vascularity does not always correlate with symptoms and vice versa. Smaller dorsal ganglia, also known as occult ganglia, are difficult to detect clinically and frequently cause local pain and limitation of movement [7]. Sonography shows them as 1-to 3-mm unilocular, anechoic cysts located near the dorsal band of the scapholunate ligament (Fig. 3). Sonography can assess their relation to the overlying extensor tendons and to the posterior interosseus nerve. In addition, sonography can assess the scapholunate ligament [8,9] and rule out effusions of the radiocarpal joint.Volar wrist ganglia usually are found near the flexor carpi radialis tendon and often displace the radial artery and its palmar branch. Color Doppler sonography easily assesses the internal flow of the artery and can differentiate ganglia from arterial pseudoaneurysms. The differential diagnosis of volar ganglia also includes tenosynovitis of the

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Ultrasonographic evaluation of wrist ganglia

Cited by 72 publications

References 18 publications

Intramuscular Cysts at the Proximal Calf: Two Case Reports and a Systematic Review of Literature

Intramuscular Cysts at the Proximal Calf: Two Case Reports and a Systematic Review of Literature

Sonography of Wrist Ganglion Cysts

Sonography of Masses of the Wrist and Hand

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