The Prevalence of Wrist Ganglia in an Asymptomatic Population: Magnetic Resonance Evaluation

Abstract

Magnetic resonance imaging (MRI) was performed on the wrists of 103 asymptomatic volunteers. The images were evaluated independently by two musculoskeletal radiologists and one orthopaedic surgeon. Wrist ganglia were identified in 53 out of the 103 wrists. The average long and short axes measurements were 8 mm (range 3-22) and 3 mm (range 2-10), respectively. Seventy per cent of the ganglia originated from the palmar capsule in the region of the interval between the radioscaphocapitate ligament and the long radiolunate ligament. Fourteen per cent of the ganglia were dorsal and originated from the dorsal, distal fibres of the scapholunate ligament. Two ganglia had surrounding soft tissue oedema and one had an associated intraosseous component. Unlike previous surgical and pathological series, our study showed that palmar wrist ganglia are more common than dorsal wrist ganglia. The vast majority of these asymptomatic ganglia occur without associated ligamentous disruption, soft tissue oedema or intraosseous communication.

Ganglions of the hand and wrist: Retrospective statistical analysis of 520 cases

“…Seventy percent of the detected ganglions were located on the volar side of the wrist. 23 This study provides evidence that ganglions can also be found in asymptomatic patients. Consequently, the incidence of ganglions in the general population is higher than calculated on the basis of the analysis of available clinical data on patients treated for symptomatic cysts.…”

“…At least several theories aimed at explaining ganglion pathophysiology exist but all of them have certain weaknesses. 12,15,[23][24][25][26] The first of these theories suggests that a ganglion is a herniation of the joint capsule (herniation of the synovial tissue from the joint). According to this concept, the fluid filling the cyst would originate from the joint and would be pumped into the cyst through a one-way valve mechanism.…”

“…11 Similarly, in the material published by Lowden et al, the majority of wrist ganglions detected on MRI examination were not accompanied by ligamentous disruption or soft tissue oedema. 23 The assumption that ligamentous pathology is the cause of ganglion formation is controversial. Taking into consideration the total incidence of all ganglions -those treated surgically, with aspiration or observation as well as undiagnosed, asymptomatic lesions, we would need to assume that ligamentous hyperlaxity of the wrist is a common condition.…”

Outcomes of Open Dorsal Wrist Ganglion Excision in Active-Duty Military Personnel

“…9 Whereas magnetic resonance imaging surveillance of asymptomatic individuals has identified a prevalence of greater than 50%, the vast majority of clinically silent cases were volar, with 14% arising from the dorsal carpus. 10 In contrast, the majority of symptomatic wrist ganglions are dorsal, most often arising from the scapholunate interosseous ligament. 10 Although most patients complain of some degree of discomfort, 11 symptoms from a dorsal wrist ganglion are generally reported as mild or minimal.…”

“…10 In contrast, the majority of symptomatic wrist ganglions are dorsal, most often arising from the scapholunate interosseous ligament. 10 Although most patients complain of some degree of discomfort, 11 symptoms from a dorsal wrist ganglion are generally reported as mild or minimal. Tomlinson and Field 5 surveyed patients presenting for common benign conditions of the hand.…”