J Korean Soc Surg Hand.  2014 Mar;19(1):7-12. 10.12790/jkssh.2014.19.1.7.

Clinical Features and Treatments of Carpal Bone Cysts

• Lee CH
• Sun DH
• Lee YM
• Song SH
• Rhee SK

• KMID: 1896921
• DOI: http://doi.org/10.12790/jkssh.2014.19.1.7

Abstract

PURPOSE
A total of 27 carpal bone cysts were analyzed for their sites, relations of other wrist soft tissue ganglions and their results of treatment were evaluated.
METHODS
Twenty-seven carpal bone cysts in 20 patients (bilateral 5, multiple 2) from February 2002 to June 2013 were evaluated. Mean follow-up period was 16.6 months. We investigated etiological classification, the site of carpal bone cyst, and their relationship with soft tissue ganglion in same wrist. Pain, range of motion, radiographic changes, and their satisfaction after treatment were assessed postoperatively.
RESULTS
The carpal bone cysts occurred mainly at the radial wrist axial ray on the lunate (12 cases), scaphoid (6 cases), and triquetrum (5 cases), trapezium (2 cases), and capitate (2 cases). Based on the magnetic resonance imaging (MRI) findings in 25 cases, we classified carpal bone cysts into 4 distinct types; type I with purely intraosseous lesion (16 cases), type II with bone cyst associated cortical perforations (6 cases), type III with coexisting soft tissue ganglion communicating with intra-osseous lesion (2 cases), and type IV with coexisting soft tissue ganglion non-communicating intraosseous lesions (1 case).
CONCLUSION
The carpal bone cysts can be classified by MRI into 4 distinct types. The purely intraosseous type is most common, suggesting the intrinsic cause in the development of carpal bone cyst.

Keyword

Bone cyst; Carpal bone

MeSH Terms

Bone Cysts
Carpal Bones*
Classification
Follow-Up Studies
Ganglion Cysts
Humans
Magnetic Resonance Imaging
Range of Motion, Articular
Wrist

Figure

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  Fig. 1. The location of carpal bone cysts.

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  Fig. 2. Anteroposterior radiograph of wrist shows radiolucent lesion on triquetrum, purely intraosseous bone cyst.

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  Fig. 3. (A) Anteroposterior radiograph of wrist shows radiolucent lesion on scaphoid. (B) Saggital computed tomography showing the lytic intraosseous ganglion on scaphoid with a sclerotic margin, expansion and perforating of the cortex.

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  Fig. 4. (A) Anteroposterior radiograph of wrist shows radiolucent lesion on scaphoid. (B) Axial T1-weighted magnetic resonance imaging shows slightly hypointensity signal change close to the volar soft tissue ganglion.

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  Fig. 5. (A) Anteroposterior radiograph of wrist shows radiolucent lesion on capitate. (B) Coronal T1-weighted magnetic resonance imaging shows tissue ganglion non-communicating with intra-osseous bone cyst on capitate. (C) The histology shows a multiloculated, cystic lesion with foci of myxoid degeneration in the surrounding stroma (H&E, ×40).

Reference

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