Case history
Case history
A 35-year-old female presents complaining of a mass located over the dorsal aspect of her wrist. She states the mass has been present for approximately 6 months and does not cause her any pain. It has slowly enlarged and is now interfering with her ability to slide on a bracelet. She claims that it has increased in size after strenuous activity and seems to shrink back to the current size with resting of the arm. She denies any paralysis or paresthesias to her hand or fingers. She has good blood flow through her radial and ulnar arteries with brisk capillary refill. The mass is fluctuant and not firmly attached to underlying structures and is not painful with palpation. The structure transilluminates when examined with a penlight.[Figure caption and citation for the preceding image starts]: Transillumination of ganglion cyst using pentorchBotte MJ et al. Musculoskeletal Key. Available at: https://musculoskeletalkey.com/ganglion-excision; used with permission; cited from Green DP et al. Green’s Operative Hand Surgery. 4th ed. New York: Churchill-Livingston, 1999: 2171-83 [Citation ends].
Other presentations
Ganglion cysts can also present on the volar aspect or occultly; however, this is less common than the dorsal variant. Presentation is usually due to cosmetic deformity; however, occasional pain, weakness, or paresthesia may be present secondary to impingement on surrounding neurologic structures, and coolness of the hand or fingers may be present secondary to radial nerve compression. Occult ganglions are usually undetectable by physical examination but may be a cause of vague wrist pain.
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