THE PREVALENCE OF WRIST GANGLIA IN AN ASYMPTOMATIC POPULATION; MAGNETIC RESONANCE IMAGING EVALUATION

Abstract

Introduction and Aims: Ganglia are commonly seen during investigation of patients with wrist pain. Our aim was to determine the prevalence of ganglia in an asymptomatic population.

Method: Following Institutional Ethical approval, Magnetic Resonance Imaging (MRI) was performed on the wrists of 103 asymptomatic volunteers. There were 67 males and 37 females, with an average age of 36, range 19–67 years. There were 52 right wrists and 51 left wrists.

Using a 1.89 Tesla surface coil Magnetic Resonance Imager the following sequences were obtained: Coronal T 1, Proton Density, T 2 and Inversion Recovery sequences; Sagittal Inversion Recovery sequences; Axial T 1 and Inversion Recovery Sequences. The images were then evaluated independently by two Muskuloskeletal Radiologists and one Orthopaedic Surgeon.

Results: Wrist Ganglia were identified in 53 out of 103 wrists. Wrist Ganglia were more prevalent in females than males, 58% compared to 48% respectively. The average long axis measurement was 7.5 mm (range 2.7–22.2), the average short axis measurement was 3.2 mm (range 1.6–10.1). Seventy percent of the Ganglia were found to originate from the volar capsule in the region of the interval between the Radio-Scapho-Capitate Ligament and the Long Radio-Lunate Ligament. Fourteen percent of the ganglia were dorsal and originated from the dorsal, distal fibres of the Scapho-Lunate Ligament. Two ganglia had surrounding soft tissue oedema and one had an associated intra-osseous component.

Conclusion: The prevalence of asymptomatic wrist ganglia is high – 51%. Unlike previous surgical and pathological series, our study showed volar wrist ganglia are more common than dorsal wrist ganglia in the asymptomatic population. The vast majority of these asymptomatic ganglia do not show associated ligamentous disruption, soft tissue oedema or intra-osseous communication.