A 38-year-old man presents with a painless, slowly progressive swelling over the volar aspect of the right wrist and palm for 6 months. The swelling is cross-fluctuant, extending above and below the flexor retinacle. There is no local warmth or tenderness. What is the most likely diagnosis?

• A Giant cell tumor of tendon sheath
• B Compound palmar ganglion (tuberculous tenosynovitis) ✓
• C Rheumatoid nodule with bursitis
• D Ganglion cyst with deep extension

Explanation

Compound palmar ganglion is the classic term for tuberculous tenosynovitis of the flexor tendons of the hand. It presents as a cross-fluctuant swelling extending above and below the flexor retinaculum, without signs of acute inflammation. Giant cell tumor is firm and non-fluctuant. Ganglion cysts do not cross the retinaculum in this manner.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.