Diagnostic validity of ultrasound in patients with persistent wirst pain and suspected occult ganglion

Österwalder, Joseph; Widrig, Reto; Stober, R; Gächter, A.

doi:10.1016/s0363-5023(97)80044-5

Cited by 37 publications

(22 citation statements)

References 19 publications

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“…Only a few series have reported their experience for detecting occult (nonpalpable) ganglions with ultrasound. 7,8,12 One small study reported a 100% detection rate for surgically proven occult dorsal ganglions in 4 wrists in 3 patients, although ganglion size was not stated. 12 A small second study reported the detection of 4 of 5 surgically proven occult ganglions with sonography.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless several recent articles and published reviews have described the sonographic features of a variety of solid and cystic lesions of the hand and wrist. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] To our knowledge only one study has assessed the efficacy, role, and limitations of ultrasound of the hand and wrist for several different types of pathologic lesions. 6 These investigators suggested that ultrasound is indicated for the diagnosis and localization of foreign bodies, diagnosis of tendon rupture and other tendon pathologies, and the diagnosis and assessment of occult ganglions.…”

mentioning

confidence: 99%

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The accuracy of high-resolution ultrasound for evaluating focal lesions of the hand and wrist

Teefey

Middleton

Patel

et al. 2004

The Journal of Hand Surgery

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The accuracy of high-resolution ultrasound for evaluating focal lesions of the hand and wrist

Teefey

Middleton

Patel

et al. 2004

The Journal of Hand Surgery

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“…1 Sonography has been shown to be effective in the detection of occult dorsal ganglion cysts. 1,9 Ganglion cysts of the wrist may be treated surgically or aspirated in combination with steroid injection. 10 Sonography can provide guidance for percutaneous aspiration and injection.…”

Section: Discussionmentioning

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, medicolegal concerns impact the practice patterns of many other clinicians. Whereas it is unclear when radiographs should be ordered and what findings may affect management, the role of MRI or ultrasound in the patient with an actual or suspected occult ganglion remains well supported [3], [8].…”

Section: Discussionmentioning

confidence: 99%

The Use of Routine Wrist Radiography is Not Useful in the Evaluation of Patients with a Ganglion Cyst of the Wrist

Wong

Jebson²,

Murray

et al. 2007

Hand (New York, N,Y.)

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The purpose of this study was to evaluate the cost-effectiveness of routine wrist radiography in the evaluation of patients with a wrist ganglion. In the setting of a University-based hand surgery practice, 103 consecutive patients with a dorsal or volar wrist ganglion underwent posteroanterior, lateral, and oblique radiographs of the involved wrist. There were 24 men and 79 women with an average age of 34 years (range 4-67 years). A retrospective review of the medical records was performed. Abnormalities on plain radiographs were noted in only 13 patients (13%). Findings included six cases of thumb carpometacarpal joint arthritis and one case each of an enchondroma, congenital distal radioulnar joint (DRUJ) anomaly, DRUJ degenerative changes, intraosseous ganglion, carpal boss, radiocarpal arthritis, and thumb metacarpophalangeal joint osteoarthritis. In only one case (1%) did the findings alter the management. At our institution, the professional and technical charge for three views of the wrist is $172. This confers a cost of $17,716 per therapeutically significant finding in our series. We conclude that routinely performing wrist radiography is not cost-effective in the evaluation and treatment decisionmaking process in patients with a wrist ganglion.

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Diagnostic validity of ultrasound in patients with persistent wirst pain and suspected occult ganglion

Cited by 37 publications

References 19 publications

The accuracy of high-resolution ultrasound for evaluating focal lesions of the hand and wrist

The accuracy of high-resolution ultrasound for evaluating focal lesions of the hand and wrist

Sonography of Wrist Ganglion Cysts

The Use of Routine Wrist Radiography is Not Useful in the Evaluation of Patients with a Ganglion Cyst of the Wrist

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