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Abstract
Background: Cystic lesions of the carpal bones are rare entities that are infrequently reported in the literature. Scaphoid intraosseous cystic lesions represent a rare subset of carpal bone cysts. This review aims to summarize the available evidence on the evaluation and treatment of scaphoid cystic lesions to help guide clinical management. Methods: Systematic electronic searches were performed using PubMed, Ovid, and Embase databases. Studies included were graded for their risk of bias. Pooled descriptive statistics were performed on incidence, etiology, physical exam findings, treatment, and follow-up. Results: A total of 38 patients representing 41 scaphoid cystic lesions were pooled from 27 articles. Patients presented with wrist pain without fracture (n = 27), pathological fracture (n = 9), swelling only (n = 1), or were asymptomatic (n = 4). Cystic lesions of the scaphoid were initially revealed on imaging with radiographs alone (n = 22), radiographs in combination with computed tomography (CT) (n = 10) or magnetic resonance imaging (n = 6), CT alone (n = 1), or using all 3 modalities (n = 2). Intraosseous ganglia were identified most frequently (n = 31), followed by "bone cyst-like pathological change" (n = 3), unicameral bone cysts (n = 2), aneurysmal bone cysts (n = 2), primary hydatid cysts (n = 2), and cystic like changes post fall (n = 1). Treatment modalities included curettage and bone graft (n = 39) or below-elbow cast (n = 2). On follow-up (average of 21.3 months; n = 40), all patients improved clinically after treatment and were found to have full wrist range of motion without pain (n = 31), slightly reduced grip strength (n = 3), limited range of motion (n = 2), or persistent mild discomfort (n = 2). Conclusions: Scaphoid cystic lesions are most commonly intraosseous ganglia, but can include other etiologies as well. The main presenting symptom is radial wrist pain that usually resolves after treatment. The presence of intracarpal cystic lesions should be considered in the differential diagnosis of wrist pain.
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Affiliation(s)
| | | | - Becher Al-Halabi
- Division of Plastic and Reconstructive
Surgery, McGill University Health Center, Montreal, Quebec, Canada
| | - Hassan Al-Naeem
- Division of Plastic and Reconstructive
Surgery, McGill University Health Center, Montreal, Quebec, Canada
| | - Sabrina Cugno
- Division of Plastic and Reconstructive
Surgery, McGill University Health Center, Montreal, Quebec, Canada
- Sabrina Cugno, Department of Plastic and
Reconstructive Surgery, McGill University Health Center, 1001 Decarie Boulevard
B05.3029, Montreal, Québec, Canada H4A 3J1.
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Salunke AA, Singh S, Kanani H, Chokshi J, Nambi GI, Raval P, Vala P, Jain S, Chaudhari S, Patel A, Panchal R. Intraosseous Ganglion Cyst of Scaphoid: An Uncommon Cause of Radial Wrist Pain. J Hand Surg Asian Pac Vol 2018; 21:109-12. [PMID: 27454514 DOI: 10.1142/s242483551672005x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Intraosseous ganglion cyst is a rare bone tumor and the lesion could often be missed. The diagnosis could be delayed so proper radiologic investigation and index of suspicion is necessary .Differential diagnoses of painful cystic radiolucent carpal lesion are osteoid osteoma, osteoblastoma and intraosseous ganglion. Curettage of the scaphoid lesion and filling of void with bone graft provides good functional outcomes. The cyst contains mucoid viscous material without epithelial or synovial lining. We present a case of 30 years old male with intraosseous ganglion cyst of scaphoid which was treated with curettage and bone grafting. Rarely ganglion cyst is found in small bones of hand and should be considered as differential diagnosis of chronic radial wrist pain.
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Affiliation(s)
- Abhijeet Ashok Salunke
- * Department of Orthopedics, Pramukswami Medical College, Karamsad-388325, Anand, Gujarat, India
| | - Saranjeet Singh
- † Department of Orthopedic Surgery, Pramukswami Medical College, Karamsad, Anand, Gujarat, India
| | - Himanshu Kanani
- † Department of Orthopedic Surgery, Pramukswami Medical College, Karamsad, Anand, Gujarat, India
| | - Jimmy Chokshi
- † Department of Orthopedic Surgery, Pramukswami Medical College, Karamsad, Anand, Gujarat, India
| | - G I Nambi
- ‡ K.M.Nallasamy Hospital, Erode, India
| | - Pradyumna Raval
- § Tayside Orthopedic Rehabilitation Technology Centre, University of Dundee, Scotland
| | - Pathik Vala
- † Department of Orthopedic Surgery, Pramukswami Medical College, Karamsad, Anand, Gujarat, India
| | - Shantanu Jain
- † Department of Orthopedic Surgery, Pramukswami Medical College, Karamsad, Anand, Gujarat, India
| | - Sanjay Chaudhari
- ∥ Department of Pathology, Pramukswami Medical College, Karamsad, Anand, Gujarat, India
| | - Amit Patel
- * Department of Orthopedics, Pramukswami Medical College, Karamsad-388325, Anand, Gujarat, India
| | - Ramesh Panchal
- * Department of Orthopedics, Pramukswami Medical College, Karamsad-388325, Anand, Gujarat, India
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3
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Abstract
Intraosseous cysts of the carpal bones are an infrequent cause of chronic wrist pain. The main body of work has investigated their occurrence in the proximal carpus, with limited incidence in the distal row. We review the current literature on the treatment of symptomatic carpal cysts following the report of a 17-year-old male with a 12-month history of progressive right wrist pain due to an intraosseous ganglion of the trapezoid. This review explores the pathology of carpal cysts, their varying presentation and current treatments.
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Affiliation(s)
- Liza Osagie
- Department of Trauma and Orthopaedics, St George’s Hospital, Blackshaw Road, London, SW17 0QT UK
| | - Samantha Gallivan
- Department of Trauma and Orthopaedics, St George’s Hospital, Blackshaw Road, London, SW17 0QT UK
| | - Neil Wickham
- Department of Trauma and Orthopaedics, St George’s Hospital, Blackshaw Road, London, SW17 0QT UK
| | - Shamim Umarji
- Department of Trauma and Orthopaedics, St George’s Hospital, Blackshaw Road, London, SW17 0QT UK
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4
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Abouchane M, Belmoubarik A, Benameur H, Nechad M. [Bilateral intraosseous synovial cyst of the carpal scaphoid revealed by pathological fracture: report of a case and review the literature]. Pan Afr Med J 2015; 21:315. [PMID: 26587163 PMCID: PMC4633747 DOI: 10.11604/pamj.2015.21.315.6451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 03/31/2015] [Indexed: 11/21/2022] Open
Abstract
Nous rapportons l'observation d'un jeune patient qui présente un kyste synovial intraosseux (KSIO) du scaphoïde révélé par une fracture pathologique. Le kyste synovial intraosseux du scaphoïde constitue une étiologie très rare des douleurs du poignet encore plus des fractures et la forme bilatérale associe à une fracture demeure une entité exceptionnelle, non décrite dans la littérature.
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Affiliation(s)
- Merouane Abouchane
- Service de Chirurgie Traumatologique et Orthopédique Aile 4, CHU Ibn Rochd, Casablanca, Maroc
| | - Amine Belmoubarik
- Service de Chirurgie Traumatologique et Orthopédique Aile 4, CHU Ibn Rochd, Casablanca, Maroc
| | - Hamza Benameur
- Service de Chirurgie Traumatologique et Orthopédique Aile 4, CHU Ibn Rochd, Casablanca, Maroc
| | - Mohammed Nechad
- Service de Chirurgie Traumatologique et Orthopédique Aile 4, CHU Ibn Rochd, Casablanca, Maroc
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5
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Lao LF, Li QY, Zhong GB, Liu ZD. Intraosseous ganglion of the scaphoid: a case report and review of published reports. Orthop Surg 2014; 6:252-4. [PMID: 25179362 DOI: 10.1111/os.12121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 03/17/2014] [Indexed: 11/29/2022] Open
Affiliation(s)
- Li-feng Lao
- Department of Orthopaedic Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Maurel B, Le Corroller T, Bierry G, Buy X, Host P, Gangi A. Treatment of symptomatic para-articular intraosseous cysts by percutaneous injection of bone cement. Skeletal Radiol 2013; 42:43-8. [PMID: 22526875 DOI: 10.1007/s00256-012-1392-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 12/06/2011] [Accepted: 02/27/2012] [Indexed: 02/02/2023]
Abstract
PURPOSE To describe the technique and clinical outcome of percutaneous injection of bone cement in the treatment of symptomatic para-articular intraosseous cysts. MATERIALS AND METHODS Five patients (three men, two women; mean age 35 years) with painful para-articular intraosseous cysts were treated by percutaneous injection of bone cement under combined fluoroscopic and computed tomography (CT) guidance. The lesions were all located in weight-bearing bones, involving the acetabulum, proximal tibia, distal tibia, talus, and calcaneus, respectively. RESULTS The average amount of bone cement injected was 2.1 ml (range, 0.6-3.5 ml). Calcium phosphate cement was used in four cases and acrylic cement in one case. There were no immediate or delayed complications. Full pain relief was obtained between 1 and 4 weeks after treatment. All patients made a complete recovery and were pain-free at their last visit. CONCLUSIONS Percutaneous injection of bone cement was a safe and efficient technique in the management of symptomatic para-articular intraosseous cysts in our population.
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Affiliation(s)
- Boris Maurel
- Service de Radiologie Interventionnelle non Vasculaire, Nouvel Hôpital Civil, 1 Place de L'Hôpital, BP 426, 67 091, Strasbourg Cedex, France.
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7
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Dumas P, Georgiou C, Chignon-Sicard B, Balaguer T, Lebreton E, Dumontier C. [Intra-osseous ganglion cyst of the carpal bones. A review of the literature underlining the importance of systematic computed tomography]. ACTA ACUST UNITED AC 2013; 32:3-7. [PMID: 23218682 DOI: 10.1016/j.main.2012.10.163] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Revised: 08/21/2012] [Accepted: 10/10/2012] [Indexed: 11/21/2022]
Abstract
The intraosseous ganglion cyst (IOGC) is a benign and lytic bone tumor affecting mostly the metaphyseal and epiphyseal regions of long bones. Its location on the short bones, including the carpal bones has been little reported in the literature. Our review of the literature shows consensus about the surgical techniques to use, but there is currently no real consensus about its pathophysiology, and its diagnostic work-up. Complications related to this lesion (mainly the risk of pathologic fracture) are potentially serious, and can cause irreversible damage. They therefore require accurate assessment to guide the choice of medical or surgical treatment, including a CT scan, which - we believe - is essential.
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Zejjari H, Louaste J, Cherrad T, Kasmaoui H, Chakoura M, Rachid K. [Intraosseous ganglion cyst of the capitate: a case report]. ACTA ACUST UNITED AC 2012; 31:262-5. [PMID: 23022265 DOI: 10.1016/j.main.2012.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Revised: 05/09/2012] [Accepted: 07/01/2012] [Indexed: 10/28/2022]
Abstract
Intraosseous cyst of the carpal bones is a rare cause of wrist pain. Few cases have been reported. We report a rare case of intraosseous ganglion cyst of the capitate, in a girl aged 16 who plain of chronic pain of the right wrist. The radiological assessment showed an osteolytic lesion with marginal sclerosis. The diagnosis was confirmed by histopathology and treatment consisted of curettage with autologous cancellous bone graft. At 8 months follow-up, the capitate is fully consolidated and the functional result is satisfactory.
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Affiliation(s)
- H Zejjari
- Service de chirurgie traumatologique et orthopédique de l'hôpital militaire Moulay-Ismail, BP S15, Meknès, Maroc.
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Paparo F, Fabbro E, Piccazzo R, Revelli M, Ferrero G, Muda A, Cimmino MA, Garlaschi G. Multimodality imaging of intraosseous ganglia of the wrist and their differential diagnosis. Radiol Med 2012; 117:1355-73. [DOI: 10.1007/s11547-012-0875-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Accepted: 09/30/2011] [Indexed: 02/06/2023]
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Mnif H, Koubaa M, Zrig M, Jawahdou R, Sahnoun N, Abid A. Ganglion cyst of the carpal navicular. A case report and review of the literature. Orthop Traumatol Surg Res 2010; 96:190-3. [PMID: 20417919 DOI: 10.1016/j.rcot.2010.02.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2008] [Accepted: 06/24/2009] [Indexed: 02/02/2023]
Abstract
Intraosseous ganglion (IOG) cyst of the scaphoid is an infrequent cause of hand and wrist pain. Intraosseous ganglia located in the scaphoid have rarely been described in the literature. We report the case of a 30-year-old right-handed woman who presented with a more than 24-month history of progressive right-wrist pain. No history of trauma was reported.Conservative treatment with anti-inflammatory medications before referral was unsuccessful. Examination revealed a small palpable mass in the carpal navicular region with no limitation of normal wrist motion. An IOG cyst of the scaphoid was found on standard radiograph and CT-scan of the wrist. Treatment consisted in curettage of the cyst followed by packing of the defect with autologous cancellous bone graft harvested in the distal end of the radial metaphysis. Satisfactory functional recovery was achieved. The clinical, radiographic and therapeutic aspects of this rare condition are discussed by the authors.
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Affiliation(s)
- H Mnif
- Department of orthopaedics and traumatology, Monastir hospital, rue 1-Juin, 5000 Monastir, Tunisia. mnif
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