Incidence and Risk Factors for Volar Wrist Ganglia in the U.S. Military and Civilian Populations.
OBJECTIVE
To identify the incidence and demographic factors associated with volar wrist ganglia in both military and civilian beneficiary populations.


METHODS
The U.S. Department of Defense Management Analysis and Reporting Tool (M2) accesses a comprehensive database of all health care visits by military personnel and their dependents. Because there is no specific code for ganglions of the wrist, the database was searched for all military personnel and civilian beneficiaries with an International Classification of Diseases, 9th Revision, diagnosis of 727.41 (ganglion of a joint) or 727.43 (ganglion, unspecified location) between 2009 and 2014. Two random samples of 1000 patients were selected from both the military and the civilian beneficiary cohorts, and their electronic medical records were examined to identify those with volar wrist ganglia. The proportion of volar wrist ganglia was then applied to the overall population data to estimate the total incidence with a 95% confidence interval and 5% margin of error. Unadjusted incidence rates and adjusted incidence rate ratios were determined using Poisson regression, controlling for age, sex, branch of military service, and military seniority.


RESULTS
The unadjusted incidence of volar wrist ganglia is 3.72 per 10,000 person-years (0.04%/y) in female civilian beneficiaries, 1.04 per 10,000 person-years (0.01%/y) in male civilian beneficiaries, 7.98 per 10,000 person-years (0.08%/y) in female military personnel, and 3.73 per 10,000 person-years (0.04%/y) in male military personnel. When controlled for age, military personnel have a 2.5-times increased rate of volar wrist ganglia, and women have a 2.3-times increased rate. In the military cohort, female sex, branch of service, and seniority were significantly associated with the diagnosis of a volar wrist ganglion when controlled for age. In the civilian beneficiary cohort, only female sex was significant.


CONCLUSIONS
Military service members have higher rates of volar wrist ganglia diagnoses than their age- and sex-matched civilian counterparts. Women are significantly more likely to be diagnosed with a volar wrist ganglion, regardless of age or military status.


CONCLUSIONS
The epidemiology of volar wrist ganglia is poorly defined, and few studies have firmly defined demographic factors associated with the diagnosis. We provide the overall incidence rate of the diagnosis and report a significant association with female sex even when controlled for age.
Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, MD.
George C
GC
Balazs
Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, MD.
Theodora C
TC
Dworak
Johns Hopkins University School of Medicine, Baltimore, MD.
Jordan
J
Tropf
Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, MD.
George P
GP
Nanos
Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, MD. Electronic address: scott.tintle@gmail.com.
Scott M
SM
Tintle
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D012307:Risk Factors; D017678:Sex Distribution; D013581:Synovial Cyst / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D014953:Wrist; D055815:Young Adult
United States; Volar wrist ganglion; epidemiology