PubMed · 5671867
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Z Dobrowolski, J Homik. 1968-01-15. [Isolated bone cysts].. https://pubmed.ncbi.nlm.nih.gov/5671867/
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A 48-year-old man presented with pain in the right wrist. A roentgenogram showed symmetrically located, well-demarcated lucencies in both scaphoids. These lesions showed homogeneous intermediate signal intensity on T1-weighted MR images and homogeneous high signal intensity on T2*-weighted MR images. Histopathological analysis revealed the lesion in the right hand as an intraosseous ganglion. The reason why the lesions were located on the palmar side is discussed.
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Intraosseous ganglion cysts are rare causes of hand and wrist pain. Differential diagnosis of painful cystic radiolucent carpal lesions includes osteoid osteoma and osteoblastoma. Isolated cases of ganglion cysts occurring in the lunate, scaphoid, pisiform, hamate, triquetrum, capitate, metacarpal, and phalanx have been reported. A case of intra-articular intraosseous ganglion cyst of the scaphoid is presented. A 49-year-old right-handed woman presented with a 3- to 4-month history of progressive left-wrist pain. No history of trauma was reported. Conservative treatment with anti-inflammatory medications before referral was unsuccessful. Examination revealed marked tenderness in the region of the volar scaphoid proximal pole as well as tenderness overlying the dorsal radial styloid. No palpable masses were present. Wrist motion was not limited. Grip strength was symmetric. Radiographic studies revealed a cystic lesion eroding the radial-volar surface of the scaphoid waist. Magnetic resonance imaging studies demonstrated the cystic lesion to be of the penetrating type, originating from the radiocarpal joint and eroding into the scaphoid. The patient underwent radial styloidectomy, excision of the ganglion cyst, curettage of the scaphoid lesion, and bone grafting with radial styloid bone. Intraosseous carpal ganglion cysts, although rare, present with chronic wrist pain and should be included in the differential diagnosis.