Ultrasound of Ganglion Cyst & Wrist Anatomy Review

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Radiology Lectures | Radquarters

Daniel J. Kowal, MD

75 episodes

2 weeks ago

High-yield, educational radiology lectures utilizing a multimodality imaging approach including MRI, CT, ultrasound, radiography, and nuclear medicine. Lectures are presented in both didactic and quiz formats. These video podcasts are designed for radiology residents, fellows, and radiologists, as well as any student or practitioner interested in optimizing patient care through radiology. Visit www.radiologistHQ.com for more info and reference material.

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Ultrasound of Ganglion Cyst & Wrist Anatomy Review

Radiology Lectures | Radquarters

12 minutes 44 seconds

2 years ago

Ultrasound of Ganglion Cyst & Wrist Anatomy Review

In this radiology lecture, we review the ultrasound appearance of ganglion cysts while highlighting relevant wrist ultrasound anatomy!
Key teaching points include:

* Ganglion cysts are viscous, mucin-filled collections lacking a synovial lining
* Most commonly occur at hand/wrist = Most common wrist mass
* Location: Dorsum of wrist (60%), frequently adjacent to scapholunate ligament; volar wrist (20%), often between radial artery and flexor carpi radialis tendon; flexor tendon sheath (10%); associated with DIP joint (10%)
* Grows out of tissues surrounding joint like a balloon on a stalk. May see a pedicle connecting to joint
* Usually well-defined and multilocular, can be unilocular
* Hypoechoic to anechoic with posterior acoustic enhancement
* Noncompressible: Dorsal joint recess and bursal collections will typically collapse with transducer pressure or wrist movement
* Typically no vascular flow, but septations may have vascularity. May see pulsation artifact from adjacent radial artery
* Volar cysts can extend towards median nerve and may cause carpal tunnel syndrome
* May displace or envelop radial artery
* Tx: Watchful waiting, percutaneous US-guided aspiration and steroid injection, excision
* Lister’s tubercle is a useful landmark for dorsal wrist anatomy
* Relevant dorsal extensor tendons (from radial side to ulnar): Compartment 2 = Extensor carpi radialis longus, extensor carpi radialis brevis, Compartment 3 = Extensor pollicis longus (on ulnar side of Lister’s tubercle), Compartment 4 = Extensor digitorum and extensor indicis
* Flexor carpi radialis overlies the ventral aspect of the scaphoid bone
* Pisiform and scaphoid bone form the proximal “twin peaks” of the carpal tunnel at the ventral wrist crease
* Median nerve diameter increase of 2 mm2 or more = Significant compression

To learn more about the Samsung RS85 Prestige ultrasound system, please visit: https://www.bostonimaging.com/rs85-prestige-ultrasound-system-4
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