Lunate intraosseous ganglion cysts and chronic wrist pain- reporting six cases

Intraosseous ganglion (IOG) cysts rarely have been reported in the carpal bones and lunate is the most common area of involvement. They can present as chronic wrist pain accompanied by a radiolucent lytic lesion in the lunate bone. We provided a retrospective review of six cases of intraosseous ganglion cysts within the lunate bones that all of the patients presented with chronic wrist pain.

We retrospectively reviewed the medical records, pathologic reports and imaging files of the six patients who were referred and treated due to chronic wrist pain with final diagnosis of the lunate intraosseous ganglion. All cases were treated by curettage and autologous cancellous bone grafting.

There were six patients with final diagnosis of the lunate IOG who received surgical treatment. Four out of six patients were female and the remaining was male. Mean age of the patients was 33 years (22 - 56). Right wrist was involved in four patients. Pain was the chief complain in all patients. Mean time of suffering from the wrist pain till referring to hand clinic for definite treatment was nine months (3 - 24). Mean duration of follow up was 30.6 months (6 - 48). The wrists became pain free after surgical treatment and no graft absorption or recurrences were seen in the control radiographs obtained throughout the follow-up period.

Diagnosis of intraosseous ganglion was based on the imaging features and clinical presentation. Although most cases of the lunate bone IOGs are symptom free and found incidentally after wrist imaging performed for other reasons, these lytic lesions should be included in differential diagnosis list of chronic wrist pain especially in the presence of increased uptake in bone scan located on the lunate area.