Features of syntopy and pathomorphology of the dorsal ganglions

   This study extends our ongoing investigation of wrist joint ganglion, which was initiated in 2022, with preliminary findings published in 2024.    The purpose of the present phase  was to perform a detailed analysis of the syntopic relationships and pathomorphological features of ganglion with dorsal localization on the wrist joint.    The study included 20 patients (18 women and 2 men) diagnosed with a dorsal ganglion of the wrist joint. Treatment was conducted at the clinic of the Autonomous Non-Profit Organization “Institute of Microsurgery” (Tomsk, Russia) from January 2022 to March 2023. Age of the patients ranged from 18 to 49 years, with an average of (39 ± 16) years. The pathology localization was distributed as follows: in 14 cases, the lesion was identified in the right wrist joint, and in 6 cases – in the left. All participants had an isolated form of the disease, without associated degenerative or traumatic changes in the hand. This was confirmed by clinical examinations, ultrasound diagnostics, and magnetic resonance imaging conducted during the preoperative preparation stage. Surgical intervention was performed under local infiltration anesthesia using a 1 % lidocaine solution. The ganglion was removed using an open method with threefold optical magnification. During the surgical procedure, the synoptic relationship of the ganglion was studied, and a fragment of the wrist joint capsule was collected at the site of the ganglion stalk attachment for subsequent morphological analysis. As control material, 7 samples of the wrist joint capsule were used, obtained postmortem from individuals without pathologies in this area, under the conditions of a pathological anatomy bureau. The obtained samples were fixed in 10 % neutral buffered formalin and subjected to histological examination with hematoxylin and eosin staining. The study confirms that dorsal ganglion originate from the capsule of the wrist joint in the area of the scapholunate ligament. Histological analysis of the removed capsule section, to which the ganglion stalk was attached, revealed that its structure consists of dense fibrous connective tissue with rare zones of hyalinization. Pronounced foci of myxomatous changes were also observed, accompanied by active proliferation of fibroblast-like cells and mononuclear infiltration. It was established that the joint capsule and the volar ganglion share a similar histological structure.