Orthopedics Book

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Ganglion Cyst

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  1. Epidemiology
    1. Most common soft tissue mass in hand
    2. Adults affected most commonly
    3. Young children may be affected
      1. Subsides by age 2 to 3 years in most cases
  2. Pathophysiology
    1. Cyst contains mucinous material
    2. Stalk attaches cyst to tendon sheath or joint
  3. Symptoms
    1. Freely movable mass over joint or tendon
    2. Local pain or weakness
      1. Occult ganglion cyst may cause dorsal Wrist Pain
      2. Ganglion may be hidden by overlying extensor tendon
    3. Dorsal wrist most commonly affected
  4. Signs
    1. Ganglion cyst on wrist dorsum
    2. Ganglion cyst more prominent with wrist flexed
  5. Management
    1. Ganglion Cyst Aspiration
    2. Compression dressing applied for 48 to 72 hours
    3. Consider splinting wrist for several days
    4. Indications for Surgical excision of ganglion cyst
      1. Symptoms persist
      2. Despite aspiration and steroid injection 1 to 2 times
  6. Course
    1. Spontaneous resolution without treatment: 53%
    2. Recurrence within 2 to 5 years after treatment
      1. Recurrence after surgical excision: 42%
      2. Recurrence after aspiration: 47%
    3. References
      1. Dias (2003) J Hand Surg 28:172

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