gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie
74. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie
96. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie
51. Tagung des Berufsverbandes der Fachärzte für Orthopädie und Unfallchirurgie

26. - 29.10.2010, Berlin

Necessity of routine pathological examination following surgical excision of wrist ganglions

Meeting Abstract

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  • T. G. Guitton - MGH, Boston, United States
  • D. Ring - MGH, Boston, United States

Deutscher Kongress für Orthopädie und Unfallchirurgie. 74. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 96. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 51. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 26.-29.10.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocIN18-1665

DOI: 10.3205/10dkou112, URN: urn:nbn:de:0183-10dkou1129

Published: October 21, 2010

© 2010 Guitton et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objective: The value of routine pathological evaluation of ganglion cysts is questionable considering that the pretest odds of a wrist lesion being a ganglion cyst is usually very high based on physical examination and operative findings alone. This study evaluates the necessity of routine pathological examination of specimens derived from surgical removal of wrist ganglion cysts.

Methods: Four-hundred-twenty-nine consecutive adult patients that underwent surgical excision of a wrist ganglion with routine pathological examination of the specimen between 1997 and 2008 were identified. The rates of concordant, discrepant, and discordant diagnoses were reported with 95 percent confidence intervals. The odds of a discrepant or discordant diagnosis were calculated.

Results and conclusions: The prevalence of a concordant diagnosis was 98.6% (424 of 429) (95 percent confidence interval, 97.3 to 99.6 percent). The prevalence of a discrepant diagnosis was 1.4% (5 of 429) (95 percent confidence interval, 0.38 to 2.7 percent) and the prevalence of a discordant diagnosis was zero. The odds ratio was 0.012 for a discrepant diagnosis and zero for a discordant diagnosis.

This study suggest that in patients with the clinical diagnosis of wrist ganglion cyst, the quality of care would not be compromised by abandoning of the practice of routine submission of surgical specimens for pathological examination after excision of the ganglion cyst. Discrepant diagnoses are encountered infrequently and discordant diagnoses did not occur. We recommend pathological examination only when the clear gelatinous fluid typical of a ganglion cyst is not encountered at surgery.