Wk 1, Case 4 - Review

Patient History
31-year-old female with possible mass or ganglion pseudocyst.

Findings

ALIGNMENT:
Ulnar Variance: Neutral.

Distal Radioulnar Joint: Normal.

Carpal Instability: Stable.

ARTICULATIONS:
Thumb Carpometacarpal Joint: Normal.

Scaphotrapeziotrapezoidal Joint: Normal.

Pisiform-Triquetral Joint: Normal.

Radiocarpal Joint: Normal.

Distal Radioulnar Joint: Normal.

Fluid: None.

Carpal Effusion: None.

Distal Radioulnar Joint Effusion: None.

INTRINSIC LIGAMENTS:
Scapholunate Ligament: Intact.

Lunotriquetral Ligament: Intact.

Triangular Fibrocartilage: The disc proper of the TFCC is intact. A small, lobulated cystic structure likely representing a capsulosynovial cyst is seen at the level of the meniscus homologous. The triangular ligament/ligamentum subcruentum is intact.

Lunate Facet: Normal.

Hamate-Lunate Facet: Normal.

Extensor Compartment: A well-circumscribed, dumbbell-shaped cystic structure measuring about 1.7cm x 1cm (transverse and CC diameters) is seen in the dorsal aspect of the wrist protruding through the extensor carpi radialis brevis and extensor pollicis longus tendon sheaths. No evidence of tendon tears or tenosynovitis.

Flexor Compartment: No flexor tendinopathy.

Carpal Tunnel: Normal.

Median Nerve: Normal diameter and signal intensity.

Flexor Retinaculum: Without thickening.

Guyon's Canal: No space-occupying lesions.

Impressions
1. A 1.7cm x 1cm dumbbell-shaped cystic structure in the dorsal aspect of the wrist protruding between the 2nd and 3rd extensor compartments in keeping with a ganglion pseudocyst.
2. Small, lobulated capsulosynovial cyst at the level of the meniscus homologous. The TFCC is otherwise intact.