Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a palpable, non-tender mass on the dorsal aspect of the right wrist. Reports intermittent aching discomfort exacerbated by wrist extension and repetitive activity. Denies history of acute trauma, numbness, paresthesia, or constitutional symptoms. Mass size fluctuates; patient reports no significant change in skin color or temperature over the lesion.
Clinical Examination Findings
Right wrist examination reveals a firm, well-circumscribed, non-pulsatile mass measuring [X] cm, located over the scapholunate interval. Mass is mobile, non-tender to palpation, and demonstrates positive transillumination. Wrist range of motion is full but limited at terminal extension due to mechanical impingement. Neurovascular status is intact distally; capillary refill <2 seconds, sensation intact to light touch in median, ulnar, and radial nerve distributions.
Treatment Protocol
Discussion regarding conservative management vs. intervention. Options include observation, aspiration with or without corticosteroid injection, or surgical excision. Patient counseled on high recurrence rates associated with aspiration. If surgical, plan for formal excision of the cyst and its stalk under local or regional anesthesia. Post-procedure immobilization in a volar splint for 7-10 days followed by physical therapy.