CASE 5888 Published on 09.05.2007

Multiple cysts in carpal bones

Section

Musculoskeletal system

Case Type

Clinical Cases

Authors

Avijit Barai

Patient

76 years, male

Clinical History
A 76 years old genteman presented with pain in the left wrist and fever. After laboratory tests and radiological investigations, it was diagnosed as a case of multiple cysts in the carpal bones.
Imaging Findings
A 76 years old gentleman came to the Emergency Department with a history of pain in the left wrist that was of sudden onset, mild to moderate in intensity, aggravated by movement and relieved by rest. He had also mild fever for some days. On examination, there was tenderness in the carpal bones. No neurological dificit was detected. Movement of wrist was slightly restricted. But that of the fingers was within normal range. Clinically, it was diagnosed as a case of Septic arthritis of the left wrist. However, the radiological investigations were suspicious. Initially, plain xray of left wrist was taken that revealed a cystic lesion in the trapezoid (Fig1). Then MRI scan of the wrist was done. That confirmed multiple cysts in the trapezoid and lunate bones (Fig2).
Discussion
Cystic lesions in the carpal bones are not very rare 1. But their presentation, origin and mechanism may vary from patient to patient. There were some cases reported as cysts in the carpal bones 1,2,3,4. Some of them were reported to have history of injury/ trauma 1, some were neoplastic 4, one was aneurysmal cyst 2, one was ganglion cyst 3 while others were of unknown origin. In our case, there was no history of trauma and the presentation was that of septic arthritis of the wrist. The MRI and x-ray were sufficient investigative tools for diagnosis. The patient was treated with surgical curettage. His post-operative outcome was quite satisfactory.
Differential Diagnosis List
Multiple cysts in carpal bones.
Final Diagnosis
Multiple cysts in carpal bones.
Case information
URL: https://www.eurorad.org/case/5888
DOI: 10.1594/EURORAD/CASE.5888
ISSN: 1563-4086