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Ultrasonographic Examination on Patients with Chronic Wrist Pain: A Retrospective Study

Chen, Hsin-Shui MD; Chen, Meng-Ye MD; Lee, Chun-Ye MS; Kao, Mu-Jung MS; Wang, Tyng-Guey MD

American Journal of Physical Medicine & Rehabilitation: November 2007 - Volume 86 - Issue 11 - p 907-911
doi: 10.1097/PHM.0b013e3181588041
Research Article: Ultrasound

Chen H-S, Chen M-Y, Lee C-Y, Kao M-J, Wang T-G: Ultrasonographic examination on patients with chronic wrist pain: a retrospective study. Am J Phys Med Rehabil 2007;86:907–911.

Objective: To describe the results of ultrasonographic examination in a series of patients with chronic wrist pain and to define the proportion of occult carpal ganglion in these patients.

Design: A retrospective study including 57 patients with wrist pain consecutively referred for sonographic examination. The inclusion criteria for this study were a history of wrist pain longer than 3 mos with no wrist trauma, and no palpable mass at the wrist. Ultrasound examination with a 10-MHz linear transducer was used to detect wrist pathology. A well-demarcated anechoic mass with posterior enhancement and without vascularity within the mass on sonography was defined as a ganglion cyst.

Results: Thirty-three of the 57 patients (58%) were diagnosed by sonographic examination as having a ganglion in the wrist joint. The size of the ganglion demonstrated on sonographic imaging ranged from 2 × 5 mm to 10 × 9 mm on a longitudinal scan of the wrist (with a mean of 4 × 7 mm.). Surgical excision was carried out in 12 patients who had ganglions diagnosed by sonographic examination; in all cases, the mucin content of the specimen was demonstrated. Eight patients underwent local aspiration followed by steroid injection under the guidance of ultrasound. The aspirated content was a jelly-like substance. In these 20 treated patients, symptoms of wrist pain improved after intervention.

Conclusions: The prevalence of occult carpal ganglion is common in chronic wrist pain patients. High-resolution sonographic examination facilitates early detection of occult carpal ganglion.

From the Departments of Physical Medicine and Rehabilitation (H-SC) and Orthopedics (M-YC, C-YL), China Medical University, Bei-Gang Hospital; Department of Physical Medicine and Rehabilitation, Taipei City Hospital, Taipei, Taiwan (M-JK); and Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan (T-GW).

All correspondence and requests for reprints should be addressed to Tyng-Guey Wang, 7 Chung-Shan South Road, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.

© 2007 Lippincott Williams & Wilkins, Inc.