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Published on: January 11, 2019
Flexor Tendon Sheath Ganglion Causing Concurrent Trigger Wrist and Carpal Tunnel Syndrome
Mohamed Alsharif1, Abdulaziz Mhannayeh1, Abdullah Jabri1
1College of Medicine, Alfaisal University, Riyadh, Saudi Arabia, alfaisal.edu.
Introduction:
Trigger wrist is a rare condition often misdiagnosed as trigger finger or carpal tunnel syndrome (CTS). It is characterized by painful clicking, snapping, or locking of the wrist during movement and can result from space-occupying lesions, such as ganglion cysts. This case highlights an unusual presentation of trigger wrist associated with CTS caused by a ganglion cyst in the flexor tendon sheath.
Case Presentation:
A 44-year-old male presented with paresthesia, severe pain, and triggering of the right wrist. Imaging and histopathology confirmed a ganglion cyst between the flexor digitorum profundus tendons of the index and middle fingers, compressing the median nerve and causing CTS. Surgical excision via a carpal tunnel approach resulted in complete symptom resolution.
Conclusion:
This case emphasizes the diagnostic challenges of trigger wrist and the importance of considering it in patients with CTS-like symptoms and mechanical wrist dysfunction. Ganglion cysts in flexor tendon sheaths are rare, and surgical excision remains an effective treatment. Increased awareness and reporting of such cases can improve clinical recognition and management.
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