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.