Ganglion Cysts of the Wrist

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Ganglion Cysts of the Wrist

By Learn MSK Sono FEATURING Jamie Bie, RMSKS, RVT, RDMS

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June 12, 2023

Do you want to know the most common sites for ganglion cysts of the wrist ...
read more ↘ and how to assess them?

Clinical presentation:
Ganglion cysts commonly occur on both sides of the wrist and will present as a fluid filled palpable lump without a synovial lining. They are often asymptomatic, but can cause pain, deformity in the wrist, and compression of the radial artery or the superficial branch of the radial nerve. Any of these findings may warrant an ultrasound guided aspiration or surgical resection.

Ultrasound appearance:
Simple ganglion cysts appear as avascular, anechoic lesions with posterior acoustic enhancement, but internal echoes or septations may be present.

Location:
🔹 If the patient presents with a cyst on the dorsal surface of the wrist, it typically lies within the joint capsule superficial to the dorsal band of the scapholunate ligament.

🔹 On the other side of the wrist along the volar surface, ganglion cysts usually originate from the scaphotrapezium joint and extend proximally towards the distal radius.

Protocol:
1️⃣ Take grayscale images with and without the surrounding structures labeled

2️⃣ Obtain a volume measurement by obtaining 2 images in the long axis and 1 measurement in the short axis

3️⃣ Use the color doppler images to confirm a lack of vascularity within the cystic lesion and distinguish it from a radial artery pseudoaneurysm
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