Ultrasonographic examination on patients with chronic wrist pain: a retrospective study.
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.


METHODS
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 x 5 mm to 10 x 9 mm on a longitudinal scan of the wrist (with a mean of 4 x 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.
Department of Physical Medicine and Rehabilitation, China Medical University, Bei-Gang Hospital, Taipei City Hospital, Taipei, Taiwan.
Hsin-Shui
HS
Chen
Meng-Ye
MY
Chen
Chun-Ye
CY
Lee
Mu-Jung
MJ
Kao
Tyng-Guey
TG
Wang
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D045888:Ganglion Cysts / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D014463:Ultrasonography; D014955:Wrist Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery