Mucous Cyst Impormasyon

Ano ang nararamdaman mo

Maaaring mapansin mo ang isang maliit, may likido na buntong-hininga sa itaas ng iyong daliri, karaniwan ay malapit sa huling kasukasuan. Ito ay isang mucous cyst. Madalas itong pakiramdam ay parang malambot na bula sa ilalim ng balat. Maaaring hindi ka mararamdaman ng sakit sa simula. Gayunpaman, habang lumalaki ang cyst, maaari itong pindutin ang mga malapit na tisyu. Ang presyong ito ay madalas na nagdudulot ng mahinang sakit o tenderness. Ang hindi komportableng pakiramdam ay karaniwang lumalala kapag gumagamit ng iyong daliri para sa mga gawain sa pagkapit o pagpipikot.

Ang cyst ay nasa malapit sa nail bed. Habang lumalaki ito, maaari itong itulak ang nail plate. Ang presyong ito ay maaaring magdulot ng mga guhit o ridges na bumubuo sa iyong kuko. Maaaring makita mo ang kuko na nagiging misshapen o bahagyang itinataas mula sa balat. Sa ilang kaso, ang balat sa itaas ng cyst ay nagiging manipis at makintab. Maaari itong maramdaman na mahigpit o sensitibo sa paghawak. Kung ang balat ay masira, maaari itong magdulot ng impeksyon, kaya mahalagang huwag itong piliin.

Ang mga araw-araw na gawain ay maaaring maging mahirap. Ang mga simpleng galaw tulad ng pag-button ng damit o pag-ikot ng doorknob ay maaaring masakit. Ang pag-abot sa likod ng iyong likod para i-fasten ang bra o pagtupi ng damit ay maaaring mag-strain sa apektadong daliri. Maaaring makita mong iwasan mo ang ilang mga galaw upang maiwasan ang sakit. May mga taong nag-uulat na lumala ang mga sintomas pagkatapos ng matagalang paggamit ng kamay. May iba namang nakakaramdam ng stiffness kapag gising sila sa umaga. Ang sakit ay maaari ring magdisturb sa iyong tulog kung ikaw ay pahinga ng iyong kamay sa paraang nagpapatibay ng presyon sa buntong-hininga.

Dahil ang mga cyst na ito ay konektado sa wear-and-tear arthritis sa kasukasuan, maaari mo ring mararamdaman ang pangkalahatang stiffness sa kasukasuan ng iyong daliri. Ang sakit ay madalas na localized sa likod ng daliri. Ito ay bihirang kumalat sa ibang bahagi ng kamay. Gayunpaman, ang patuloy na pag-aalala sa buntong-hininga ay maaaring magdisturb. Maaari mong makita ang sarili mong madalas na sinusuri ang laki ng cyst o nag-aalala sa itsura nito. Ang pag-unawa sa mga sintomas na ito ay tumutulong sa iyong pamamahala ng iyong araw-araw na rutina at naghahanda sa iyo para sa susunod na hakbang sa iyong pag-aalaga.

Ano ang nangyayari talaga

Ang mucous cyst ay isang maliit, puno ng likido na bag na bumubuo malapit sa kasukasuan ng iyong daliri o paa. Ito ay nasa itaas ng kasukasuan, madalas ay malapit sa nail bed. Ang likido sa loob nito ay makapal at malagkit, katulad ng lubricant na tumutulong sa paggalaw ng iyong mga kasukasuan nang maayos.

Ang cyst na ito ay hindi impeksyon. Ito ay direktang resulta ng wear-and-tear arthritis sa kasukasuan. Habang tumatanda ang kasukasuan, ang makinis na cartilage na sumasakop sa mga dulo ng buto ay nagsisimulang masira. Bilang tugon, sinusubukan ng iyong katawan na ayusin ang pinsala sa pamamagitan ng pagbuo ng maliliit na bone spurs, kilala bilang osteophytes, sa mga gilid ng kasukasuan.

Isipin ang joint capsule bilang isang mahigpit na manggas na nakapalibot sa iyong kasukasuan. Ang bone spur ay tumutulak sa manggas na ito mula sa loob. Sa paglipas ng panahon, ang patuloy na presyon ay lumilikha ng mahinang bahagi sa dingding ng capsule. Ang likido ng kasukasuan ay tumatagas sa pamamagitan ng mahinang bahaging ito at nakapupulong sa ilalim ng balat, na bumubuo sa kitang-kitang bubong na iyong nakikita.

Ang cyst mismo ay sa halip ay isang lobo na puno ng likido ng kasukasuan. Dahil ito ay bumubuo direkta sa itaas ng kasukasuan, maaari itong pindutin ang mga kalapit na istruktura. Kung ito ay malapit sa kuko, maaari itong pindutin ang ugat ng kuko, na nagdudulot ng mga guhit o ridges sa iyong nail plate. Maaari rin nitong gawing manipis at mahina ang balat sa itaas ng cyst.

Ang pag-alis lamang ng cyst ay madalas na hindi sapat. Kung nananatili ang underlying bone spur, patuloy itong tutulak sa joint capsule. Ang presyong ito ay karaniwang nagdudulot ng pagtagas ulit ng likido, na nagdudulot ng pagbabalik ng cyst. Upang itigil ang siklong ito, kailangang tugunan ang pinagmulan ng presyon.

Ang aming approach ay nakatuon sa pag-alis ng parehong cyst at bone spur na nagdudulot ng iritasyon. Sa pamamagitan ng pagpapakinis ng gilid ng buto, tinatanggal namin ang puwersa na tumutulak ng likido palabas mula sa kasukasuan. Tinitiyak nito na ang joint capsule ay makakagaling nang maayos nang walang pagtagas ulit. Pinapagaling namin din nang maingat ang joint capsule upang lumikha ng matibay na selyo, na pumipigil sa pagbuo ulit ng likido sa hinaharap.

Ano ang maaari naming gawin dito

Ang pamamaraan ni Dr. Kieran Hirpara, isang surgeon sa upper-limb sa Mater Private Hospital Rockhampton, na ginagamit sa aming klinika ay sumasalamin sa paraan ng pamamahala namin sa kondisyong ito. Dumating ang mga pasyente sa aming klinika sa pamamagitan ng referral mula sa GP o physiotherapist. Isang pagsusuri sa klinika (kasaysayan, pagsusuri, at pag-imaging kung kinakailangan) ang nagtatatag ng diagnosis. Para sa mga degenerative o matagal nang problema, karaniwang sinusubukan namin ang non-operative care — pagbabago ng aktibidad, physiotherapy o hand therapy, paggamit ng splint, at mga injection — at pinag-aaralan ang surgery kapag hindi ito nagbigay ng sapat na pagpapabuti. Para sa mga structural o acute na problema, maaaring irekomenda agad ang surgery, nang walang nakaraang non-operative trial.

Maaari kang magsimula sa pagprotekta sa lugar na apektado. Iwasan ang mga gawain na naglalagay ng pressure sa cyst o sa joint. Maaaring gabayan ka ng iyong physiotherapist sa mga banayad na galaw upang panatilihin ang mobility ng joint at bawasan ang stiffness. Layunin ng conservative care na ito na pamahalaan ang mga sintomas at pababain ang pag-unlad nito. Karaniwang inirerekomenda namin na bigyan ng patas na trial ang pamamaraang ito sa loob ng ilang linggo upang makita kung nagbibigay ito ng ginhawa.

Kung mananatili ang mga sintomas, tatalakayin namin ang mga opsyon sa medical management. Ang mga gamot pang-alis ng sakit at anti-inflammatory drugs ay makakatulong upang bawasan ang discomfort at pamamaga. Sa ilang kaso, maaaring irekomenda namin ang injection sa loob ng joint o cyst. Ang mga cortisone injection ay makakapagpahupa ng inflammation sa limitadong panahon. Ang mga hyaluronic acid injection ay maaaring maglubricate ng joint upang mapabuti ang galaw. Ang mga Platelet-rich plasma (PRP) injection ay gumagamit ng sarili mong blood components upang suportahan ang paggaling. Nag-iiba-iba ang tagal ng ginhawa para sa bawat tao at uri ng treatment.

Isinasalang-ala ang surgery kapag ang conservative care ay hindi nagbigay ng sapat na pagpapabuti o kung ang cyst ay nagdudulot ng malaking sakit o deformity ng kuko. Ang layunin ng aming surgical procedure ay alisin ang cyst at ang underlying bone spur na nagdudulot nito. Ang pag-alis ng bone spur ay susi upang maiwasan ang pagbalik ng cyst. Layunin namin ang kumpletong resolusyon sa karamihan ng mga kaso. Sa ilang mga teknik, tinatanggal din namin ang bahagi ng joint lining upang matiyak na mananatiling malinis ang lugar. Ang pamamaraang ito ay nagpakita ng mababang rate ng pagbalik na 1.4% sa mga maaasahang treatment, kasama ang mataas na kasiyahan ng mga pasyente tungkol sa scar at kahandaan na subukan muli ang prosedura. Tatalakayin namin ang mga opsyong ito sa iyo upang makagawa ng shared decision tungkol sa pinakamainam na landas.

Ano ang inaasahan

Ang mucous cyst ay isang bula na puno ng likido na karaniwang bumubuo malapit sa huling kasukasuan ng iyong daliri o hinlalaki. Madalas itong lumalaki nang dahan-dahan sa loob ng panahon. Kung walang gamutan, maaaring manatili o magbago ang laki ng cyst. Minsan, ito ay nagdudulot ng sakit o nagiging sanhi ng hirap sa pagbaluktot ng kasukasuan. Kung iiwan ito, bihira itong mag-ayos nang sarili at maaaring magpatuloy na makaapekto sa iyong mga pang-araw-araw na gawain.

Kapag pinamamahalaan nang may angkop na alaga, ang prognosis ay karaniwang positibo. Ang pagsasagawa ng operasyon para alisin ang cyst at ang nasa ilalim na bone spur (osteophyte) ay isang maaasahang paraan upang gamutin ang kondisyon. Ang pamamaraang ito ay nag-aalis ng cyst na may napakababa o halos walang pagkakataon ng pagbabalik nito. Sa ilang kaso, ang pag-alis lamang ng bone spur nang hindi inaalis ang cyst mismo ay maaari ring magdulot ng kumpletong paglaya sa karamihan ng mga pasyente. Ang ibang mga teknik, tulad ng buong pag-alis ng lining ng joint capsule o paggamit ng local skin flaps upang takpan ang lugar, ay epektibo rin. Ang mga pamamaraang ito ay nagpapakita ng mababang mga rate ng pagbabalik, na may ilang pag-aaral na nagpapakita ng rate ng pagbabalik na 1.4% lamang.

Maaari kang mag-expect ng mataas na kasiyahan sa cosmetic na resulta pagkatapos ng operasyon. Karamihan sa mga pasyente ay masaya sa itsura ng peklat at pipiliin na gawin muli ang prosedura. Ang mga pagbabalik, kung mangyari, ay karaniwang lumalabas nang maaga pagkatapos ng unang operasyon. Ito ang dahilan kung bakit mahalaga ang regular na mga appointment para sa follow-up. Ang iyong surgeon ay magmamanman sa lugar upang siguraduhing hindi babalik ang cyst at upang suriin ang anumang ibang pagbabago.

Ang paggaling ay kinabibilangan ng pagprotekta sa surgical site habang ito ay gumagaling. Kailangan mong panatilihing malinis ang lugar at mag-ingat sa mga senyales ng impeksyon. Karamihan sa mga tao ay bumabalik sa normal na paggamit ng kamay habang ang paggaling ay nag-uunlad, ngunit sundin ang tiyak na payo ng iyong surgeon kung kailan muling magsimula ng mabigat na paghawak o pag-angat. Ang layunin ay ibalik ang komportableng galaw at alisin ang bula. Sa tamang gamutan, maaari kang mag-expect na mawawala ang cyst at malaking pagpapabuti ang mararamdaman sa function ng kasukasuan.

Kailan makipag-ugnayan sa isang espesyalista

Humingi ng pagsusuri ng espesyalista kung mapansin mo ang maliit na buntis sa malapit sa iyong kuko ng daliri. Maaaring magkaroon ng mucous cyst ng mga malabong senyales, kaya madali itong mapalampasin sa maagang yugto. Pumunta sa iyong doktor kung ang lugar ay naging masakit at hindi umuunlad sa pamamagitan ng pahinga. Humingi ng tulong kung nararamdaman mo ang kahinaan, kawalan ng katatagan, o kung ang kasukasuan ay nakakabara o bumabagsak. Makipag-ugnayan sa amin kung ang mga sintomas ay nakakaapekto sa iyong tulog o trabaho. Biglaang paglala ng sakit o pamamaga ay nangangailangan din ng pagsusuri. Ang regular na mga follow-up ay tumutulong upang maiwasan ang pagbabalik o iba pang pagbabago. Ang maagang atensyon ay tumutulong upang maiwasan ang mga komplikasyon at panatilihin ang mahusay na pag-andar ng iyong daliri.

Evidence & references

Overview

Scientific data regarding mucous cysts consist almost entirely of retrospective studies [1].
Much of the management or recommendations for mucous cysts is based on expert opinion [1].
Total dorsal capsulectomy alone is a simple treatment for mucous cysts that does not lead to any recurrence [2].
Excision of the cyst combined with complete removal of the marginal osteophyte eradicates mucous cysts with extremely rare recurrence [3].
Osteophyte excision without cyst excision may be a good treatment choice for mucous cysts of the finger, providing a less invasive method with complete resolution in most cases [5].
Osteophyte removal results in a low cyst recurrence rate, indicating it should be undertaken regardless of the surgeon's plan for the soft tissues [13].
The Zitelli bilobed flap allows excision of the cyst and thinned skin with no added risk to the nail matrix [6].
The use of a Wolfe graft for mucous cysts is simple, easy to perform, and provides satisfactory cosmesis with acceptable recurrence rates [7].
Surgical excision with a local advancement skin flap is a reliable treatment for digital mucous cysts, demonstrating a low recurrence rate of 1.4% and high patient satisfaction regarding the scar and willingness to undergo the procedure again [9].
A surgical technique involving excision of the cyst, synovectomy, and débridement of osteophytes with rotational flap closure resulted in no recurrences in thirty-six patients [10].
Pathohistological analysis is useful in cases where doubts arise about the initial diagnosis of a benign tumorous lesion [4].
Eccrine porocarcinomas have a substantial risk of metastasis, high risk of local recurrence, and are potentially fatal [8].

Anatomy & Pathophysiology

Scientific data regarding mucous cysts consist almost entirely of retrospective studies [1].
Much of the management or recommendations for mucous cysts is based on expert opinion [1].
Mucous cysts are associated with marginal osteophytes at the distal interphalangeal joint [3].
The primary pathology in mucous cysts involves osteophytes, and removal of these osteophytes allows for skin recovery potential [20].
Ultrasound is a powerful modality for evaluating pathologic conditions in the hand and wrist [16].
Ultrasound provides a cost-effective and expedient alternative or adjunct to MRI for hand and wrist evaluation [16].
Ultrasound is best used when there is a specific clinical question regarding a well-localized abnormality [16].
Pathohistological analysis is useful in cases where doubts arise about the initial diagnosis of a benign tumorous lesion [4].
Subungual keratoacanthoma may show locally aggressive behaviour but does not metastasize [14].

Classification

Scientific data regarding mucous cysts consist almost entirely of retrospective studies [1].
Much of the management or recommendations for mucous cysts is based on expert opinion [1].
Total dorsal capsulectomy alone is a simple treatment for mucous cysts that does not lead to any recurrence [2].
Excision of the cyst combined with complete removal of the marginal osteophyte eradicates mucous cysts with extremely rare recurrence [3].
Pathohistological analysis is useful in cases where doubts arise about the initial diagnosis of a benign tumorous lesion [4].
Osteophyte excision without cyst excision may be a good treatment choice for mucous cyst of the finger, providing a less invasive method with complete resolution in most cases [5].
The Zitelli bilobed flap allows excision of the cyst and thinned skin with no added risk to the nail matrix [6].
The use of a Wolfe graft is simple, easy to perform, and provides satisfactory cosmesis with acceptable recurrence rates [7].
Eccrine porocarcinomas have a substantial risk of metastasis, high risk of local recurrence, and are potentially fatal [8].
Surgical excision with a local advancement skin flap is a reliable treatment for digital mucous cysts, demonstrating a low recurrence rate of 1.4% and high patient satisfaction regarding the scar and willingness to undergo the procedure again [9].
A surgical technique involving excision of the cyst, synovectomy, and débridement of osteophytes with rotational flap closure resulted in no recurrences in thirty-six patients [10].
There is a statistically significant difference in recurrence rates between Type I giant cell tumours of the tendon sheath (0%) and Type II tumours (38%) [11].
Recurrence in Type II giant cell tumours of the tendon sheath is likely due to undetected satellite lesions or incomplete excision [11].
Incomplete excision of a granular cell nerve tumor can lead to recurrence [12].
Osteophyte removal results in a low cyst recurrence rate [13].
Osteophyte removal should be undertaken regardless of the surgeon's plan for the soft tissues [13].

Clinical Presentation

Scientific data regarding mucous cysts consist almost entirely of retrospective studies [1].
Much of the management or recommendations for mucous cysts is based on expert opinion [1].
Malignant natural-killer cell neoplasms can present as a mucous cyst on the distal interphalangeal joint of the finger [4].
Eccrine porocarcinomas can present as a hand cyst [8].
Subungual keratoacanthoma may present as a condition masquerading as flexor tenosynovitis in the finger [14].
Ultrasound is a powerful modality for the evaluation of pathologic conditions in the hand and wrist [16].
Ultrasound provides a cost-effective and expedient alternative and/or adjunct to MRI for hand and wrist evaluation [16].
Ultrasound is best used when there is a specific clinical question regarding a well-localized abnormality in the hand or wrist [16].

Investigations

Scientific data regarding mucous cysts consist almost entirely of retrospective studies [1].
Much of the management of mucous cysts is based on expert opinion [1].
Pathohistological analysis is useful when doubts arise about the initial diagnosis of a benign tumorous lesion [4].
Eccrine porocarcinomas have a substantial risk of metastasis, high risk of local recurrence, and are potentially fatal [8].
Ultrasound is a powerful modality for evaluation of pathologic conditions in the hand and wrist [16].
Ultrasound provides a cost-effective and expedient alternative and/or adjunct to MRI [16].
Ultrasound is best used when there is a specific clinical question regarding a well-localized abnormality [16].

Treatment

Scientific data regarding mucous cysts consist almost entirely of retrospective studies, and much of what is done or recommended is based on expert opinion [1].
Total dorsal capsulectomy alone is a simple treatment for mucous cysts that does not lead to any recurrence [2].
Excision of the cyst and complete removal of the marginal osteophyte eradicates mucous cysts with extremely rare recurrence [3].
Osteophyte excision without cyst excision may be a good treatment choice for mucous cyst of the finger, providing a less invasive method with complete resolution in most cases [5].
Osteophyte removal results in a low cyst recurrence rate, indicating that it should be undertaken regardless of the surgeon's plan for the soft tissues [13].
The Zitelli bilobed flap allows excision of the cyst and thinned skin with no added risk to the nail matrix [6].
Use of Wolfe graft is simple, easy to perform, and provides satisfactory cosmesis with acceptable recurrence rates [7].
Surgical excision with a local advancement skin flap is a reliable treatment for digital mucous cysts, demonstrating a low recurrence rate of 1.4% and high patient satisfaction regarding the scar and willingness to undergo the procedure again [9].
A surgical technique involving excision of the cyst, synovectomy, and débridement of osteophytes with rotational flap closure resulted in no recurrences in thirty-six patients [10].
Pathohistological analysis is useful in cases where doubts arise about the initial diagnosis of a benign tumorous lesion [4].

Complications

Scientific data regarding mucous cysts consist almost entirely of retrospective studies, with many recommendations based on expert opinion [1].
Total dorsal capsulectomy alone for mucous cysts did not lead to any recurrence [2].
Excision of the cyst and complete removal of the marginal osteophyte eradicates mucous cysts with extremely rare recurrence [3].
Osteophyte excision without cyst excision may provide complete resolution in most cases [5].
The Zitelli bilobed flap allows excision of the cyst and thinned skin with no added risk to the nail matrix [6].
Use of a Wolfe graft provides satisfactory cosmesis with acceptable recurrence rates [7].
Surgical excision with a local advancement skin flap demonstrates a low recurrence rate of 1.4% and high patient satisfaction regarding the scar [9].
A surgical technique involving excision of the cyst, synovectomy, and débridement of osteophytes with rotational flap closure resulted in no recurrences in thirty-six patients [10].
Incomplete excision can lead to recurrence of granular cell nerve tumors [12].
Type II giant cell tumors of the tendon sheath have a 38% recurrence rate, likely due to undetected satellite lesions or incomplete excision [11].
Malignant natural-killer cell neoplasms can present as mucous cysts on the distal interphalangeal joint [4].
Pathohistological analysis is useful in cases where doubts arise about the initial diagnosis of a benign tumorous lesion [4].
Eccrine porocarcinomas have a substantial risk of metastasis, high risk of local recurrence, and are potentially fatal [8].

Recovery

Scientific data regarding mucous cysts consist almost entirely of retrospective studies [1].
Much of the treatment for mucous cysts is based on expert opinion [1].
Total dorsal capsulectomy alone is a simple treatment for mucous cysts that does not lead to any recurrence [2].
Excision of the cyst and complete removal of the marginal osteophyte eradicates mucous cysts with extremely rare recurrence [3].
Osteophyte excision without cyst excision may be a good treatment choice for mucous cysts of the finger, providing a less invasive method with complete resolution in most cases [5].
The Zitelli bilobed flap allows excision of the cyst and thinned skin with no added risk to the nail matrix [6].
The use of a Wolfe graft is simple, easy to perform, and provides satisfactory cosmesis with acceptable recurrence rates [7].
Surgical excision with a local advancement skin flap is a reliable treatment for digital mucous cysts, demonstrating a low recurrence rate of 1.4% and high patient satisfaction regarding the scar and willingness to undergo the procedure again [9].
Pathohistological analysis is useful in cases where doubts arise about the initial diagnosis of a benign tumorous lesion [4].
Eccrine porocarcinomas have a substantial risk of metastasis, high risk of local recurrence, and are potentially fatal [8].
Incomplete excision can lead to recurrence in granular cell nerve tumors [12].

Key Evidence

[L4] The scientific data regarding mucous cysts consist almost entirely of retrospective studies, and much of what is done or recommended is based on expert opinion. [1] (10.1016/j.jhsa.2010.01.029)
[L4] A total dorsal capsulectomy alone was a simple treatment for mucous cysts and did not lead to any recurrence. [2] (10.1016/j.jhsa.2014.03.004)
[L4] Excision of the cyst and complete removal of the marginal osteophyte eradicates mucous cysts with extremely rare recurrence. [3] (10.2106/00004623-197355030-00013)
[L5] This case emphasizes the utility of a pathohistological analysis in cases where doubts arise about the initial diagnosis of a benign tumorous lesion. [4] (10.1007/s00402-008-0794-4)
[L4] Osteophyte excision without cyst excision may be a good treatment choice for mucous cyst of the finger, providing a less invasive method with complete resolution in most cases. [5] (10.1177/1753193413478549)
[L4] It allows excision of the cyst and thinned skin with no added risk to the nail matrix. [6] (10.1016/j.jhsa.2017.03.013)
[L4] The technique is simple, easy to perform, and provides satisfactory cosmesis with acceptable recurrence rates. [7] (10.1177/1753193408103498)
[L4] Prompt recognition and appropriate treatment are critical because eccrine porocarcinomas have a substantial risk of metastasis, high risk of local recurrence, and are potentially fatal. [8] (10.1016/j.jhsa.2016.07.112)
[L4] Surgical excision with a local advancement skin flap is a reliable treatment for digital mucous cysts, demonstrating a low recurrence rate of 1.4% and high patient satisfaction regarding the scar and willingness to undergo the procedure again. [9] (10.1177/1753193413508540)
[L4] A new surgical technique involving excision of the cyst, synovectomy, and débridement of osteophytes with rotational flap closure resulted in no recurrences in thirty-six patients. [10] (10.2106/00004623-197254070-00008)
[L3] The study found a statistically significant difference in recurrence rates between Type I tumours (0%) and Type II tumours (38%), with recurrence in Type II likely due to undetected satellite lesions or incomplete excision. [11] (10.1054/jhsb.2000.0522)
[Case_report] The author notes that while the true recurrence rate is unknown, incomplete excision can lead to recurrence. [12] (10.1016/j.jhsa.2009.05.011)
[Commentary] The article shows that osteophyte removal results in a low cyst recurrence rate, indicating that it should be undertaken regardless of the surgeon's plan for the soft tissues. [13] (10.1177/1753193413510663)
[L4] Subungual keratoacanthoma may show locally aggressive behaviour but does not metastasize. [14] (10.1177/1753193409360605)
[L5] Ultrasound is a powerful modality for evaluation of pathologic conditions in the hand and wrist, providing a cost-effective and expedient alternative and/or adjunct to MRI, best used when there is a specific clinical question regarding a well-localized abnormality. [16] (10.1016/j.jhsa.2009.02.010)
[L5] The authors of the original study believe that extensive damage to the skin is unnecessary and that the skin has recovery potential once the main problem (osteophytes) is removed, favoring a less invasive approach over techniques requiring skin flaps. [20] (10.1177/1753193414546443)

References

[1] Mucous Cysts. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2010.01.029 [2] Total Dorsal Capsulectomy for the Treatment of Mucous Cysts. The Journal of Hand Surgery. 2014. DOI: 10.1016/j.jhsa.2014.03.004 [3] Marginal Osteophyte Excision in Treatment of Mucous Cysts. The Journal of Bone & Joint Surgery. 1973. DOI: 10.2106/00004623-197355030-00013 [4] Malignant Natural-Killer cell neoplasm presenting as a mucous cyst on the distal interphalangeal joint of the finger. Archives of Orthopaedic and Trauma Surgery. 2008. DOI: 10.1007/s00402-008-0794-4 [5] Osteophyte excision without cyst excision for a mucous cyst of the finger. Journal of Hand Surgery (European Volume). 2013. DOI: 10.1177/1753193413478549 [6] The Zitelli Bilobed Flap on Skin Coverage After Mucous Cyst Excision: A Retrospective Cohort of 33 Cases. The Journal of Hand Surgery. 2017. DOI: 10.1016/j.jhsa.2017.03.013 [7] Use of Wolfe Graft for the Treatment of Mucous Cysts. Journal of Hand Surgery (European Volume). 2009. DOI: 10.1177/1753193408103498 [8] Eccrine Porocarcinoma Presenting as a Hand Cyst. The Journal of Hand Surgery. 2016. DOI: 10.1016/j.jhsa.2016.07.112 [9] A reliable surgical treatment for digital mucous cysts. Journal of Hand Surgery (European Volume). 2013. DOI: 10.1177/1753193413508540 [10] Etiology and Treatment of the So-Called Mucous Cyst of the Finger. The Journal of Bone & Joint Surgery. 1972. DOI: 10.2106/00004623-197254070-00008 [11] Giant Cell Tumours of Tendon Sheath: Classification and Recurrence Rate. Journal of Hand Surgery. 2001. DOI: 10.1054/jhsb.2000.0522 [12] Granular Cell Nerve Tumor in the Hand: Case Report. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2009.05.011 [13] Commentary on Lee et al. Osteophyte excision without cyst excision for a mucous cyst of the finger. Journal of Hand Surgery (European Volume). 2014. DOI: 10.1177/1753193413510663 [14] Metastases to the finger masquerading as flexor tenosynovitis. Journal of Hand Surgery (European Volume). 2010. DOI: 10.1177/1753193409360605 [16] Ultrasound of the Hand and Wrist. The Journal of Hand Surgery. 2009. DOI: 10.1016/j.jhsa.2009.02.010 [20] Re: Lee HJ, Kim PT, Jeon IH, et al. Osteophyte excision without cyst excision for a mucous cyst of the finger. J Hand Surg Eur. 2014, 39: 258–61. Journal of Hand Surgery (European Volume). 2014. DOI: 10.1177/1753193414546443