Last reviewed: 22 Nov 2024
Last updated: 16 Aug 2024
Summary
Definition
History and exam
Key diagnostic factors
- subcutaneous wrist mass
- wrist pain
- nontender mass
- increased mass size after activity
- transilluminating mass
Full details
Other diagnostic factors
- unable to recall onset of lump
- hand or finger coolness
- paresthesia or weakness of fingers
- reduced sensation in the hand
Full details
Risk factors
- female sex
- age 10 to 30 years
- trauma
- scapholunate instability
Full details
Diagnostic tests
1st tests to order
- no initial test
Full details
Tests to consider
- cyst aspiration
- erythrocyte sedimentation rate
- C-reactive protein
- complete blood count
- wrist x-ray
- ultrasound
- magnetic resonance imaging
Full details
Treatment algorithm
ACUTE
without neurovascular compromise
with neurovascular compromise
Contributors
Authors
Philip Blazar, MD
Associate Professor of Orthopedic Surgery
Harvard Medical School
Brigham and Women's Hospital
Boston
MA
Disclosures
PB declares that he has no competing interests.
Acknowledgements
Dr Philip Blazar would like to gratefully acknowledge Dr Marco Rizzo and Dr Kristofer S. Matullo, previous contributors to this topic.
Disclosures
MR and KSM declare that they have no competing interests.
Peer reviewers
George Chloros, MD
Fellow
Department of Orthopedic Surgery
Wake Forest University Baptist Medical Center
Winston-Salem
NC
Disclosures
GC declares that he has no competing interests.
Lorenz Buchler, MD
Senior Physician
Clinic for Orthopedic Surgery
University Hospital Bern
Bern
Switzerland
Disclosures
LB declares that he has no competing interests.
Differentials
- Carpal tunnel syndrome
- Lipoma
- Giant cell tumor of the tendon sheath
More DifferentialsGuidelines
- ACR appropriateness criteria: chronic hand and wrist pain
- ACR appropriateness criteria: soft tissue masses
More GuidelinesPatient information
Carpal tunnel syndrome
More Patient information- Log in or subscribe to access all of BMJ Best Practice
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