Necessity of Routine Pathological Examination After Surgical Excision of Wrist Ganglions

Omitting histopathology in wrist ganglions. A risky proposition

“…The female preponderance and predominantly dorsal location seen in our study has also been seen previously. 8 Recent studies 4 , 5 have recommended abandoning routine histopathological analysis as there is high concordance between clinical and histopathological diagnosis. Our study revealed a higher discordance rate (5%) as compared with these studies (1.5% and 0%).…”

“… 3 But as most of these may be differentiated on physical examination, radiology, or intraoperative assessment; recent recommendations are against the routine use of histopathological analysis of excised specimens. 4 , 5 However, there are recent case reports from our region, where tuberculosis (TB) is endemic, showing that tuberculous tenosynovitis presented as a wrist ganglion with subtle intraoperative finding of thickened synovium. 6 , 7 As TB is still prevalent in our part of the world, we decided to review the histopathology of wrist ganglia excised at our institute to study the incidence of TB and other conditions mimicking ganglia.…”

Correlation of Clinical, Operative, and Histopathologic Diagnosis of Interdigital Neuroma and the Cost of Routine Diagnosis

“…9 Evaluation of removed ganglion cysts in the wrist has similarly shown that histopathology does not change the clinical course and that physicians accurately identify those that vary from the expected findings. 6 In all cases, the expertise of the treating surgeon is a critical component to accurate diagnosis. Based on our knowledge of primary IDN, clinical examination is the most reliable method of diagnosis.…”

Routine Examination of Pathology Specimens Following Knee Arthroscopy: A Cost-Effectiveness Analysis

“…Previous studies have demonstrated extremely low diagnostic value and high costs of histological examinations following a variety of procedures, including thumb, knee, and hip arthroplasty; lumbar and cervical discectomy; hallux valgus surgery; wrist ganglion excision; and shoulder and knee arthroscopy [6][7][8][9][10][11][12][13][14][15][16][17][18][19][23][24][25][26][27][28] (see Appendix). While these represent various procedures under different settings, different clinical and histological diagnoses occurred in 0% to 9% of the cases.…”