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

Abstract

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.

Digital Sheath Synovial Ganglion Cysts in Horses

“…The proposed cause and suggested terminology of these cystic structures are schematically represented in Fig 1. Hernias result from a defect in the capsular tissue of a joint or tendon sheath through which the synovium can protrude 18,19,20,21 . Ganglion cysts do not possess synovium and the fibromyxoid lining could develop from the resultant inflammation created by the synovial fluid within the extra‐capsular tissues.…”

Deferring Routine Wrist Radiography Does Not Affect Management of de Quervain Tendinopathy Patients

“…Strengths of this study include the addition of a comparative group, which was not a component of other studies evaluating the role of radiography in the workup of other common upper extremity conditions. [1][2][3][4] This enabled us to compare frequencies of disease-specific treatments (injection or surgical release of the first dorsal compartment) between cohorts with and without radiographs, in addition to tabulating the radiographic findings and determining whether additional treatments were administered on the basis of imaging results for the single cohort with films.…”

Ganglions in the Hand and Wrist: Advances in 2 Decades

“…One intraosseous ganglion was noted, and in only one patient did radiographs change patient management. 11 Radiography may rule out radiopaque foreign bodies that present as soft-tissue masses, reveal evidence of previous surgical interventions, evaluate the scapholunate interval, or demonstrate intraosseous cysts or underlying degenerative joint disease, but the role of radiography remains limited in the evaluation of suspected ganglions.…”