Arch Hand Microsurg.  2024 Dec;29(4):258-261. 10.12790/ahm.24.0043.

Dorsal wrist ganglion originating at the volar scaphotrapeziotrapezoidal joint: a case report

• Lee HR
• Kang J
• Yun Y
• Kim J

• KMID: 2561376
• DOI: http://doi.org/10.12790/ahm.24.0043

Abstract

Ganglion cysts originating from the volar wrist joint are usually found on the volar side. A case report has described a patient with a dorsal wrist ganglion originating from the scapholunate ligament and appearing at a volar location. However, no cases of volar wrist ganglia appearing on the dorsal wrist have been reported. Herein, we present a rare case of a large dorsal ganglion cyst originating from the volar scaphotrapeziotrapezoidal (STT) joint that pierced the first dorsal interosseous muscle, leading to dorsal bulging. A 40-year-old woman presented with a progressively growing mass over the dorsal aspect of her left wrist and mild pain. Preoperative imaging showed a ganglion cyst originating from the volar side of the STT joint. The ganglion was successfully removed through open surgery. In conclusion, since ganglion cysts occurring in the dorsal wrist, especially if there is deviation to the radial side, may originate from the volar midcarpal joint, magnetic resonance imaging is necessary to reduce the risk of recurrence and minimize the likelihood of postoperative complications.

Keyword

Ganglion cyst; Wrist joint; Synovial cyst

Figure

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  Fig. 1. Magnetic resonance imaging findings of the ganglion cyst. (A) The dorsal ganglion cyst originating from the volar scaphotrapeziotrapezoidal (STT) joint (white arrow). (B) The ganglion cyst passes through the position between the superficial head and deep head of the first dorsal interosseous muscle. (C) The ganglion cyst is adherent to the radial artery (blue arrow). (D) The ganglion cyst bulged dorsally.

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  Fig. 2. Clinical presentation observed during surgery. (A) A lump formed by the ganglion cyst on the dorsum of the wrist. (B) After excision. Preservation of the radial artery (black arrow). (C) Appearance of a part of the volar scaphotrapeziotrapezoidal (STT) joint. The stalk of the ganglion cyst, arising from the volar STT joint (red arrow).

Reference

References

1. Nahra ME, Bucchieri JS. Ganglion cysts and other tumor related conditions of the hand and wrist. Hand Clin. 2004; 20:249–v.

2. Mathoulin C, Gras M. Arthroscopic management of dorsal and volar wrist ganglion. Hand Clin. 2017; 33:769–77.

3. Rocchi L, Canal A, Fanfani F, Catalano F. Articular ganglia of the volar aspect of the wrist: arthroscopic resection compared with open excision. a prospective randomised study. Scand J Plast Reconstr Surg Hand Surg. 2008; 42:253–9.

4. Wright TW, Cooney WP, Ilstrup DM. Anterior wrist ganglion. J Hand Surg Am. 1994; 19:954–8.

5. Kaempf DE Oliveira R, Farina Brunelli JP, Aita MA, Mantovani Ruggiero G. Volar wrist ganglion originating at the dorsal scapholunate ligament - a report of two patients. J Hand Surg Asian Pac Vol. 2022; 27:200–3.

6. Greendyke SD, Wilson M, Shepler TR. Anterior wrist ganglia from the scaphotrapezial joint. J Hand Surg Am. 1992; 17:487–90.

7. Chai HL, Pérez CÁ, Yu WPF, Ho PC. Arthroscopic resection of wrist scaphotrapeziotrapezoidal (STT) joint ganglia. J Wrist Surg. 2020; 9:440–5.