Ultrasound Diagnostics of Synovial Cysts of the Hand and Wrist

Чуловская, И. Г.; Егиазарян, К. А.; Skvortsova, M. A.; Лобачев, Е. В.

doi:10.21823/2311-2905-2018-24-2-108-116

Traumatology and Orthopedics of Russia

2018

DOI: 10.21823/2311-2905-2018-24-2-108-116

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Ultrasound Diagnostics of Synovial Cysts of the Hand and Wrist

И. Г. Чуловская¹,

К. А. Егиазарян²,

M. A. Skvortsova³

et al.

Abstract: Purpose– to evaluate the efficiency and rationale for a mandatory ultrasound examination of patients with synovial cysts of the hand and wrist joint.Material and methods. The authors performed examination and following treatment of 274 patients with synovial cysts of the hand from 2005 till 2017. The diagnostics was performed basing on clinical and medical history data, roentgenology findings, ultrasonographic data, intraoperative diagnostics and postoperative histological studies. When needed MRT was performe… Show more

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Cited by 4 publications

References 22 publications

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Mucous Cysts of Fingers: Diagnostics and Treatment Mistakes

Chulovskay,

Egiazaryan,

Kosmynin

et al. 2024

Traumatology and Orthopedics of Russia

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Background. Mucous cysts of hand represent tumor-like masses. This pathology is associated with a large number of diagnostic and treatment mistakes with inappropriate procedures and incomplete surgical interventions, which result in recurrences and complications. Aim of the study — to analyze diagnostics and treatment mistakes in patients with mucous cysts of fingers in order to improve the quality of medical care for patients with this pathology. Methods. The study enrolled 62 patients. Diagnostics included medical history analysis, clinical and X-ray examination, and ultrasonography. According to the patients’ history, they were divided into two groups: group 1 consisted of patients who had come to the clinic for the first time, group 2 — of patients who had referred to the clinic with recurrences of mucous cysts. All patients underwent surgical interventions with osteophyte excision of the phalanx and skin defect grafting after cyst excision. Treatment results were evaluated 2, 6, 12 months after the operation using X-ray data, VAS, QuickDash questionnaire, and measurements of the range of motion in the distal interphalangeal joint. Results. Initial referrals of group 2 patients (with disease recurrence) were analyzed in terms of the profile of specialists and the type of care provided. It was found that patients with recurrence had undergone procedures (cyst puncture, cauterization, removal of thin skin over the cyst) or surgeries without osteophyte excision of the phalanx and skin defect grafting after cyst excision. The use of a diagnostic algorithm at the referral stage made it possible to confirm the diagnosis and detect an osteophyte of the affected phalanx in all patients. Patients were followed up for a year. Conclusion. At the diagnostic stage, X-ray and ultrasonography are conclusive methods of examination. The only correct method of mucous cysts treatment is radical surgery including skin defect grafting with local tissues after cyst excision and osteophyte removal.

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Mucous Cysts of Fingers: Diagnostics and Treatment Mistakes

Chulovskay,

Egiazaryan,

Kosmynin

et al. 2024

Traumatology and Orthopedics of Russia

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Diagnosis and treatment of hygroma of the wrist joint in the practice of an outpatient surgeon

Korobkov

Malkov

Филиппов

et al. 2021

Ambulatornaya khirurgiya

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Introduction. Synovial cyst or hygroma is a common disease that occurs in both children and adults, but it is most often observed in people 20–45 years old. More than 60% of patients who go to the polyclinic with complaints about the presence of tumor-like formations have hygroma.Goal. Analysis of the results of treatment of synovial cysts of the hand and wrist joint according to our own observations and literature data.Material and methods. We observed 54 patients suffering from hygroma of the hand and wrist joint, who were treated in polyclinic No. 2 and MEDEL multidisciplinary clinic in Kazan from 2005 to 2020. The treatment of hygrom was carried out using conservative (puncture) and surgical methods. Results. Our experience showed that after a single puncture of the hygroma with the evacuation of its contents (10 patients), relapse developed in all cases. After repeated puncture of the hygroma in 10 patients with evacuation of the contents and subsequent administration of 0.5 ml of betaspan solution, 6 of them did not relapse within 5–6 months, but 4 patients had a relapse in the nearest period (1–2 months). Of the 23 patients who underwent surgery to remove the hygroma, 15 of them had no relapses. In 8 patients in the postoperative period, recurrent hygroma occurred, which could be explained by the ineffectiveness of eliminating the communication zone between the hygroma and the joint.Conclusions. For the successful treatment of this disease, it is important to understand that for the occurrence and development of hygroma, its communication with the joint cavity or tendon vagina is of great importance. In the absence of a message, the successful use of puncture methods of treatment is possible. In the presence of such a message and its detection during preoperative examination, surgical treatment should be planned with mandatory ligation of the leg of the hygroma.

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Metallic Mercury in the Soft Tissues of the Hand: Case Report

Чуловская

Егизарян

Лядова

et al. 2020

Traumatology and Orthopedics of Russia

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РефератАктуальность. Вероятность присутствия в ране инородных тел существует практически при любом повреждении кожных покровов. Последствия их внедрения в организм крайне разнообразны: от полного отсутствия симптоматики до системного токсического поражения в зависимости как от природы внедрившегося агента, так и от пути его внедрения. Данные анамнеза и клинического обследования инородных тел не всегда убедительны, а результаты традиционной рентгенографии даже при рентгенопозитивных инородных телах нередко неспецифичны. Парентеральное введение металлической ртути относится к редким повреждениям и, в отличие от внедрения через дыхательные пути и пищеварительный тракт, недостаточно изучено. Описание клинического наблюдения. В статье представлен клинический случай умышленного самовведения металлической ртути в мягкие ткани верхней конечности у пациента 24 лет, обратившегося за медицинской помощью через 2 года после травмы и пытавшегося при сборе анамнеза скрыть ее обстоятельства. Решающую роль в постановке диагноза (инородное тело) и определении его природы (металлическая ртуть) сыграло ультразвуковое исследование. Это позволило определить его высокую информативность и специфичность (превышающую возможности рентгенографии). Несмотря на отсутствие данных общего и местного токсического поражения организма больного, присутствие в организме инородного ртутного материала требует хирургического лечения. Результат операции продемонстрировал, что ртуть в мягких тканях ограничивается гранулемой или фиксируется внутри фиброзной ткани, что предоставляет возможность ее радикального удаления. Заключение. Это наблюдение позволяет утверждать, что УЗИ, в отличие от рентгенографии, способно выявить специфическую картину присутствия металлической ртути в мягких тканях. Исходя из этого, целесообразно включать этот метод в алгоритм исследования при подозрении на наличие любого инородного тела (тем более ртути) для определения или уточнения его природы. При введении ртути в мягкие ткани радикальное хирургическое лечение может быть успешно проведено, так как реакция тканей вокруг ртутного материала (в виде формирования гранулемы и заключение ртутных сфер в конгломерат фиброзной ткани) позволяет избежать распространения его элементов по раневому каналу.Ключевые слова: инородное тело, гранулема, металлическая ртуть, мягкие ткани кисти, рентгенография, ультразвуковое исследование.Источник финансирования: государственное бюджетное финансирование.

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Ultrasound Diagnostics of Synovial Cysts of the Hand and Wrist

Cited by 4 publications

References 22 publications

Mucous Cysts of Fingers: Diagnostics and Treatment Mistakes

Mucous Cysts of Fingers: Diagnostics and Treatment Mistakes

Diagnosis and treatment of hygroma of the wrist joint in the practice of an outpatient surgeon

Metallic Mercury in the Soft Tissues of the Hand: Case Report

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