Journal List > J Korean Soc Surg Hand > v.19(1) > 1106481

J Korean Soc Surg Hand. 2014 Mar;19(1):7-12. Korean.
Published online March 28, 2014.  https://doi.org/10.12790/jkssh.2014.19.1.7
Copyright © 2014. The Korean Society for Surgery of the Hand
Clinical Features and Treatments of Carpal Bone Cysts
Chul-Hyung Lee,1 Dong-Hyuk Sun,1 Youn-Min Lee,2 Suk-Hwan Song,2 and Seung-Koo Rhee1
1Department of Orthopedic Surgery, Sun General Hospital, Daejeon, Korea.
2Department of Orthopedic Surgery, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.

Correspondence to: Seung-Koo Rhee. Department of Orthopedic Surgery, Sun General Hospital, 29 Mokchung-ro Chung-gu, Daejeon 301-725, Korea. TEL: +82-42-220-8460, FAX: +82-42-252-1911, Email: skrhee@catholic.ac.kr
Received December 31, 2013; Revised February 24, 2014; Accepted February 26, 2014.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Purpose

A total of 27 carpal bone cysts were analyzed for their sites, relations of other wrist soft tissue ganglions and their results of treatment were evaluated.

Methods

Twenty-seven carpal bone cysts in 20 patients (bilateral 5, multiple 2) from February 2002 to June 2013 were evaluated. Mean follow-up period was 16.6 months. We investigated etiological classification, the site of carpal bone cyst, and their relationship with soft tissue ganglion in same wrist. Pain, range of motion, radiographic changes, and their satisfaction after treatment were assessed postoperatively.

Results

The carpal bone cysts occurred mainly at the radial wrist axial ray on the lunate (12 cases), scaphoid (6 cases), and triquetrum (5 cases), trapezium (2 cases), and capitate (2 cases). Based on the magnetic resonance imaging (MRI) findings in 25 cases, we classified carpal bone cysts into 4 distinct types; type I with purely intraosseous lesion (16 cases), type II with bone cyst associated cortical perforations (6 cases), type III with coexisting soft tissue ganglion communicating with intra-osseous lesion (2 cases), and type IV with coexisting soft tissue ganglion non-communicating intraosseous lesions (1 case).

Conclusion

The carpal bone cysts can be classified by MRI into 4 distinct types. The purely intraosseous type is most common, suggesting the intrinsic cause in the development of carpal bone cyst.

Keywords: Bone cyst; Carpal bone

Figures


Fig. 1
The location of carpal bone cysts.
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Fig. 2
Anteroposterior radiograph of wrist shows radiolucent lesion on triquetrum, purely intraosseous bone cyst.
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Fig. 3
(A) Anteroposterior radiograph of wrist shows radiolucent lesion on scaphoid. (B) Saggital computed tomography showing the lytic intraosseous ganglion on scaphoid with a sclerotic margin, expansion and perforating of the cortex.
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Fig. 4
(A) Anteroposterior radiograph of wrist shows radiolucent lesion on scaphoid. (B) Axial T1-weighted magnetic resonance imaging shows slightly hypointensity signal change close to the volar soft tissue ganglion.
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Fig. 5
(A) Anteroposterior radiograph of wrist shows radiolucent lesion on capitate. (B) Coronal T1-weighted magnetic resonance imaging shows tissue ganglion non-communicating with intra-osseous bone cyst on capitate. (C) The histology shows a multiloculated, cystic lesion with foci of myxoid degeneration in the surrounding stroma (H&E, ×40).
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Tables


Table 1
Classification of carpal bone cyst (total 25cases)
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