Evaluating dorsal wrist pain: MRI diagnosis of occult dorsal wrist ganglion.

Fourteen patients with chronic dorsal wrist pain of unknown etiology underwent high-resolution magnetic resonance imaging (MRI) examination formatted to evaluate the scapholunate interval. Ten had MRI evidence that was diagnostic for an occult dorsal wrist ganglion. The average measured 4.7 mm at greatest diameter. Eight of 10 patients had the diagnosis confirmed, 7 at the time of surgery, and 1 at follow-up examination when the ganglion enlarged and was no longer occult. The other two opted for nonoperative management. The positive predictive value of a positive MRI finding for occult dorsal wrist ganglion was 100% in this small series. The use of a properly formatted high-resolution MRI in this patient population was diagnostic for occult dorsal wrist ganglion.