Abstract
The case of a ganglion cyst in the pulp of a fifth finger in an elderly woman initially mimicking a soft tissue tumor is described. Most typical sites of ganglion cysts are well documented at the wrist and in the vicinity of inter-phalangeal and metacarpo-phalangeal joints. In this case, ultrasonography (US) and magnetic resonance imaging (MRI) demonstrated a cystic lesion within the pulp of the fifth finger and indicated carpal osteoarthritis as the distant—and unexpected—origin of the lesion. The suggested diagnosis of ganglion cyst was confirmed by computed tomography arthrography (CT arthrography) of the wrist, which showed opacification of the cyst on delayed acquisitions after intra-articular injection into the mid-carpal joint, through the fifth flexor digitorum tendon sheath. The communications between the degenerative carpal joint, the radio-ulnar bursa, the fifth flexor digitorum tendon sheath and the pedicle of the cyst were well demonstrated.
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References
Angelides AC. Ganglions of the hand and wrist. In: Green DP, editor. Operative hand surgery. Vol. 2. New York: Churchill Livingstone; 1993. p. 2171–83.
Jebson PJ, Spencer EE Jr. Flexor digitorum tendon sheath ganglions: results of surgical excision. Hand. 2007;2:94–100.
Hsu CS, Hentz VR, Yao J. Tumours of the hand. Lancet Oncol. 2007;8:157–66.
Mitchell E, Nahra MD, John S, Bucchieri MD. Ganglion cysts and other tumor related conditions of the hand and wrist. Hand Clin. 2004;20:249–60.
Steiner E, Steinbach LS, Schnarkowski P, Tirman PFJ, Genant HK. Ganglia and cysts around joints. Radiol Clin North Am. 1996;43:395–425.
Nahra ME, Bucchieri JS. Ganglion cysts and other tumor related conditions of the hand and wrist. Hand Clin. 2004;20:249–60.
Teefey SA, Dahiya N, Middleton WD, Gelberman RH, Boyer MI. Ganglia of the hand and wrist: a sonographic analysis. AJR Am J Roentgenol. 2008;191:716–20.
Malghem J, Vande Berg BC, Lebon C, Lecouvet FE, Maldague BE. Ganglion cysts of the knee: articular communication revealed by delayed radiography and CT after arthrography. AJR Am J Roentgenol. 1998;170:1579–83.
Resnick D. Arthrography, tenography and bursography. In: Resnick D, editor. Diagnosis of bone and joint disorders. 4th ed. Philadelphia: Saunders; 2002. p. 214–6.
Spinner RJ, Dellon AL, Rosson GD, Anderson SR, Amrami KK. Tibial internal ganglia in the tarsal tunnel: is there a joint connection? J Foot Ankle Surg. 2007;46:27–31.
Buckwalter JA, Dryer RF, Mickelson MR. Arthrography in juxta-articular cysts of the knee. Two cases diagnosed by delayed roentgenograms. J Bone Joint Surg Am. 1979;61:465.
McEvedy BV. Simple ganglia. Br J Surg. 1962;49:585–93.
Hvid-Hanson O. On the treatment of ganglia. Acta Chir Scand. 1970;136:471–6.
Resnick D. Roentgenographic anatomy of the tendon sheaths of the hand and wrist: tenography. AJR Am J Roentgenol. 1975;124:44–51.
Wainwright AM, Burge PD. Synovial cyst of the pulp of the little finger—origin from the wrist joint. J Hand Surg. 2002;27B:503–6.
Rosson GD, Spinner RJ, Dellon AL. Tarsal tunnel surgery for treatment of tarsal ganglion: a rewarding operation with devastating potential complications. J Am Pediatr Med Assoc. 2005;95:459–63.
Daffner RH, Whitfield PW. Recurrent ganglion cyst: the value of preoperative gangliography. AJR Am J Roentgenol. 1977;129:345–6.
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Bouilleau, L., Malghem, J., Omoumi, P. et al. Pseudotumoral ganglion cyst of a finger with unexpected remote origin: multimodality imaging. Skeletal Radiol 39, 375–379 (2010). https://doi.org/10.1007/s00256-009-0816-5
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DOI: https://doi.org/10.1007/s00256-009-0816-5