Morphology and topography of intraosseous ganglion cysts in the carpus: an anatomic, histopathologic, and magnetic resonance imaging correlation study.
OBJECTIVE
To assess the morphology, topography, frequency, and etiology of intraosseous carpal ganglions.


METHODS
Two hundred and eighty formalin fixed cadaveric wrists (mean age 80.3 +/- 9.7 years, range 40 to 101 years) were radiographed. Fifty specimens suspicious for cyst-like bone lesions underwent magnetic resonance imaging (T1w and proton density-fat-saturated images, 1.5T). Dissection, articular surface assessment, and histological examination were performed. Cystic lesions with adjacent destruction of the hyaline cartilage were classified as degenerative and were excluded.


RESULTS
In 27 of the 50 specimens, 48 ganglion cysts (GC) were found. Prevalence of GC was 9.6%. Of 48 intraosseous carpal GC, 41 (85%) were in a peripheral location; 27/48 (56%) were located at the palmar carpus. GC had a macroscopic and microscopic relationship to the insertion of degenerated ligaments. They developed near longitudinally orientated bone surfaces, which serve as insertion for ligaments and are exposed to tension loading.


CONCLUSIONS
Unlike degenerative cysts, ganglion cysts do not erode the hyaline articular cartilage and almost always have a continuity with the capsular ligaments. Intraosseous carpal ganglion cysts are probably the result of mucoid degeneration of adjacent ligaments.
Schrank
Christian
C
Anatomic Institute, Ludwig-Maximilians-University, Munich, Germany.
Meirer
Romed
R
Stäbler
Axel
A
Nerlich
Andreas
A
Reiser
Maximilian
M
Putz
Reinhard
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011859:Radiography; D013581:Synovial Cyst / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology*; D014953:Wrist