Select a Community
Are you sure you want to trigger topic in your Anconeus AI algorithm?
You are done for today with this topic.
Would you like to start learning session with this topic items scheduled for future?
>75% resolve within 1 year in pediatric patients
87%
767/877
Aspiration is recommended given the patient's age
1%
6/877
Has a true epithelial lining
5%
44/877
Transillumination of the mass suggests an alternative diagnosis
10/877
Volar palmar location is less common in this aged population
45/877
Select Answer to see Preferred Response
This patient's examination is consistent with a ganglion cyst. In the pediatric patient, observation is recommended as 76% resolve within 1 year in pediatric patients. Ganglion cysts are mucin-filled synovial cysts and are the most common masses found in the wrist and hand. Diagnosis can be made clinically with a firm and well circumscribed mass that transilluminates. Treatment is observation for the majority of ganglions, particularly in the pediatric patient population. Surgical excision is indicated for ganglion cysts associated with severe symptoms or neurovascular manifestations. Coffey et al. reviewed all hand and wrist ganglions in patients aged 12 years and younger. They reported that volar ganglions were more common (1.2:1), whereas dorsal ganglions have been reported to be more common in adults. They concluded that while observation and/or splinting alone will likely be helpful in resolution of a majority of pediatric hand and wrist ganglions, surgical excision should be employed in those that are symptomatic and/or do not resolve with observation. Wang et al. reviewed the behavior of ganglia of the hand and wrist in young children treated without surgery. They reported that none of the cysts were painful. They concluded that at a follow-up average of 33 months (range, 9-12 months), with 79% of all cysts spontaneously resolving, the majority within a year. Meyerson et al. retrospectively reviewed ganglion cysts that underwent excision in the pediatric population. They reported that indications for surgery were 96% for pain or decreased range of motion, 4% for cosmetic or parental concern. They concluded that there is approximately a 5% recurrence rate for a pediatric population with increased rates of recurrence when a cyst had been previously aspirated, possibly indicating scarring and disruption of planes resulting in difficult dissection, increased tourniquet times, and incomplete excision. Incorrect Answers: Answer 2: Aspiration is not necessary at the vast majority of ganglion cysts resolve within 1 year in the pediatric patients Answer 3: Ganglion cysts do not have a true epithelial lining Answer 4: Transillumination (transmits light through tissue) is consistent with the diagnosis of a ganglion cyst Answer 4: Dorsal carpal (70%) location is the most common and originates from SL articulation are more common in adults, whereas volar ganglions were more common (1.2:1) in the pediatric population
5.0
(1)
Please Login to add comment