A 30-year-old manual labourer presents with a painless, bilobed swelling at the front of the left wrist: one lobe lies above the flexor retinaculum and the other extends into the palm. The swelling is cross-fluctuant between the two lobes, and he complains of stiffness of the fingers. The most likely diagnosis is:
- A Compound palmar ganglion due to tuberculous tenosynovitis of the flexor sheaths ✓
- B Lipoma of the forearm
- C Simple ganglion of the wrist
- D Soft tissue sarcoma of the wrist
Correct answer: A. Compound palmar ganglion due to tuberculous tenosynovitis of the flexor sheaths
Explanation
Compound palmar ganglion results from tuberculous tenosynovitis of the flexor tendon sheaths. It forms a dumbbell shaped swelling with one part deep to the flexor retinaculum and one in the palm, showing cross-fluctuation, and produces finger stiffness. C simple ganglion arises from a joint capsule or tendon sheath near the dorsum of the wrist and is never bilobed across the retinaculum.
Reference: Tuli's Textbook of Tuberculosis of the Skeletal System, 5th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.