Journal name: World Journal of Pharmaceutical Research
Original article title: Ganglion at the wrist
The WJPR includes peer-reviewed publications such as scientific research papers, reports, review articles, company news, thesis reports and case studies in areas of Biology, Pharmaceutical industries and Chemical technology while incorporating ancient fields of knowledge such combining Ayurveda with scientific data.
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Subtitle: an uncommon presentation of rheumatoid arthritis
Original source:
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N. S. Neki, Ankur Jain, Mohit Manav and Rohit Bajaj
World Journal of Pharmaceutical Research:
(An ISO 9001:2015 Certified International Journal)
Full text available for: Ganglion at the wrist
Source type: An International Peer Reviewed Journal for Pharmaceutical and Medical and Scientific Research
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Summary of article contents:
Introduction
Rheumatoid arthritis (RA) is a systemic inflammatory condition that commonly affects joints, leading to various clinical manifestations. One of the less typical presentations of RA involves the occurrence of ganglions, which are fluid-filled cysts often found in the wrist. This case report discusses a 60-year-old male patient presenting with an uncommon ulnar-sided dorsal ganglion at the wrist, emphasizing the relationship between this complication and rheumatoid arthritis. The patient, who had a history of RA and was undergoing treatment, demonstrated symptoms that warranted further investigation and intervention.
Ulnar-Sided Dorsal Ganglions
Ulnar-sided dorsal ganglions are a rare finding in cases of rheumatoid arthritis, contrasting with more common ganglion presentations typically seen on the dorsum or volar aspect of the wrist. In this case, the patient exhibited a soft, translucent mass located on the dorsoulnar aspect of the left wrist, which had gradually progressed over two months. Diagnostic imaging revealed an accessory ossicle distal to the ulnar styloid beneath the soft-tissue mass, indicating a possible relationship between the ganglion formation and the anatomical variations present in the patient's wrist.
Diagnosis and Treatment
The excision of the wrist ganglion led to the identification of the stalk originating from a pseudarthrosis between the ulnar styloid and the accessory ossicle. Histopathological examination confirmed the diagnosis of a ganglion cyst. Post-surgery, the patient reported no further complaints and maintained full motion in the wrist, demonstrating the successful nature of the surgical intervention. This case highlights the importance of accurate diagnosis and treatment strategies for managing wrist ganglions in patients with underlying rheumatoid arthritis.
Implications of Rheumatoid Arthritis
Rheumatoid arthritis is characterized by synovial inflammation, which can result in joint damage and various extra-articular manifestations, including rheumatoid nodules and, less commonly, ganglions. The presence of wrist ganglions can often signify underlying mechanical issues or pathological changes due to the disease. This case suggests that while ganglions may be common in the general population, their specific occurrence and presentation in RA patients require careful clinical evaluation to determine the best course for management, highlighting the need for a broader understanding of the conditions associated with RA.
Conclusion
The presentation of an ulnar-sided dorsal ganglion in a patient with rheumatoid arthritis underscores the complexity of the disease and its manifestations. This case illustrates the necessity for vigilance in recognizing atypical presentations of common conditions, as well as the importance of thorough diagnostic processes that can lead to effective interventions. Ultimately, successful surgical outcomes can restore function and alleviate symptoms in affected individuals, allowing for improved quality of life. Further studies may provide additional insights into the connections between RA and ganglion cyst formations, offering pathways for better management of such complications.
FAQ section (important questions/answers):
What is the typical presentation of wrist ganglions?
Wrist ganglions usually appear on the dorsal or volar aspect, but ulnar-sided dorsal ganglions are less common and frequently arise from the scapholunate joint, spreading ulnarly.
What condition is associated with the formation of ganglions?
Ganglions are commonly associated with rheumatoid arthritis (RA), but are relatively rare in this context. They represent a benign condition that can occur due to synovial inflammation and joint damage.
How did the patient present in the case report?
The 60-year-old male patient presented with a gradually progressive swelling on the dorsoulnar aspect of the left wrist, with no prior trauma and a known history of rheumatoid arthritis.
What does the histopathology reveal about the mass?
Histopathology confirmed the diagnosis of a ganglion cyst, which was found to have gelatinous contents and was stemming from a pseudo-arthrosis between the ulnar styloid and an accessory ossicle.
What was the treatment outcome for the patient?
Post-surgery, the patient reported no further complaints, maintained full wrist motion, had a well-healed incision, and showed no signs of recurrence or sensory deficits.
What are the common sites for ganglions in the wrist?
Ganglions most commonly arise from the dorsum of the wrist, particularly near the scapholunate ligament. Ulnar-sided dorsal ganglions, however, are considered uncommon.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Ganglion at the wrist”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Rheumatoid arthritis:
Rheumatoid arthritis (RA) is a systemic inflammatory disease characterized by synovial inflammation, leading to joint damage and functional impairment. It commonly presents with extra-articular manifestations like rheumatoid nodules. In this case, the association between RA and the development of a wrist ganglion highlights the unusual complications of the disease.
2) Hand:
The hand is a critical anatomical region, particularly in this case regarding the presence of a ganglion located on the wrist, affecting functionality. The wrist and hand comprise various structures where ganglions can form, and understanding their anatomy is essential in addressing complications in patients with rheumatoid arthritis.
3) Medicine:
Medicine is the science and practice of diagnosing, treating, and preventing disease. In this case report, the management of rheumatoid arthritis and its complications underscores the role of medical knowledge and intervention. The diagnosis and surgical excision of the ganglion cyst illustrate applied medical practice in resolving patient issues.
4) India:
India is the geographic context of the case study, with the patient receiving care at Government Medical College/Guru Nanak Dev Hospital in Amritsar. This setting emphasizes the diversity of healthcare scenarios and challenges faced in a country with a high prevalence of rheumatoid arthritis and related complications.
5) Guru:
Guru refers to Guru Nanak Dev Hospital, significant in this context as it is the institution where the case study occurred. The hospital's role in providing medical education and care emphasizes the importance of research and clinical practice in improving patient outcomes, particularly in managing complex diseases like RA.
6) Inflammation:
Inflammation is a key pathological process in rheumatoid arthritis, leading to joint damage and systemic symptoms. In this case, synovial inflammation contributed to the formation of the ganglion cyst, highlighting the interconnectedness of inflammatory processes and secondary complications that can affect patients with RA.
7) Discussion:
The discussion section of the report analyzes insights from the case, linking it to broader implications in rheumatology. It provides commentary on existing literature, examining how ganglions are relatively common in the wrist and hand, especially in RA patients, thus contributing to clinical understanding of the disease.
8) Swelling:
Swelling is a primary symptom presented by the patient, indicating a possible underlying pathology. In this case, the swelling on the dorsoulnar aspect of the wrist signaled the presence of a ganglion cyst, emphasizing the importance of swelling as a clinical clue in diagnosing complications in rheumatoid arthritis.
9) Incision:
Incision refers to the surgical cut made to excise the ganglion cyst in this case. The well-healed incision post-surgery demonstrates the successful removal of the mass and underscores the surgical approach as a treatment for complications arising in patients with rheumatoid arthritis.
10) Disease:
Disease pertains to rheumatoid arthritis, which is a chronic condition affecting the joints. The case illustrates how RA can lead to various complications, such as the formation of a ganglion. Understanding the disease's complexities aids in managing its varied symptoms and associated health issues.
11) Pain (Paiṇ):
Pain is a common symptom experienced by individuals with rheumatoid arthritis, often due to joint damage and inflammation. In this case, although the patient had a ganglion, the report notes a lack of pain, indicating that the presence of a ganglion does not always correlate with discomfort in RA patients.
12) Male (Mālē):
The patient in this case report is a 60-year-old male, highlighting demographic considerations in rheumatoid arthritis presentations. Gender can influence disease manifestation, progression, and treatment responses, making it relevant to understand how male patients might experience RA differently than females.
Other Science Concepts:
Discover the significance of concepts within the article: ‘Ganglion at the wrist’. Further sources in the context of Science might help you critically compare this page with similair documents:
Rheumatoid arthritis, Surgical treatment, Physical examination, Outpatient department, Joint damage, Chief complaint, Histopathology, Wrist ganglions, Ulnar-sided dorsal ganglions, Accessory ossicle, Pseudo-arthrosis, Hemogram, Elevated ESR, Ganglion cyst, Full motion, Dorsoulnar aspect, Dorsal ganglion, Extra-articular manifestation, Sensory deficit, Soft tissue mass, Accessory ulnar styloid variant.