Case Study: Ganglion Cyst

Patient Information:

Name: Shahzaib Malik

Age: 32 years

Gender: Male

Occupation: Office Manager

Socioeconomic Status: Middle class

Presenting Complaints:

Shahzaib Malik presented to the clinic with a visible lump on the dorsum of his left wrist. He reported experiencing mild discomfort and occasional pain around the lump. He was concerned about the appearance of the lump and its potential impact on his daily activities.

History of Presenting Complaints:

Shahzaib noticed the lump approximately six months ago. He attributed its appearance to frequent typing and computer use at work. The lump seemed to fluctuate in size, occasionally becoming smaller but never completely disappearing. The discomfort and pain were aggravated when he engaged in repetitive wrist movements or put pressure on the lump.

Chief Complaints:

Visible lump on the dorsum of the left wrist

Mild discomfort and occasional pain

Concerns about appearance and functional limitations

Past Medical and Surgical History:

Shahzaib had no significant past medical or surgical history. He reported being in generally good health and had not experienced any major illnesses or injuries in the past.

Family History:

There was no family history of ganglion cysts or other musculoskeletal conditions.

Socioeconomic Status:

Shahzaib belonged to the middle-class socioeconomic group. He had a stable job as an office manager and had access to basic healthcare services.

Present and Pre-morbid Functional Status:

Before the appearance of the cyst, Shahzaib had a normal functional status. He was able to perform his daily activities and job responsibilities without any limitations.

General Health Status:

Shahzaib’s general health was good, with no ongoing medical conditions or chronic illnesses.

Vitals:

Blood pressure: 120/80 mmHg

Heart rate: 76 beats per minute

Respiratory rate: 16 breaths per minute

Temperature: 98.6°F (37°C)

Aggravating Factors:

Repetitive wrist movements and pressure on the lump aggravated the discomfort and pain.

Easing Factors:

Rest and avoiding activities that put strain on the wrist provided relief from discomfort.

Examination:

On physical examination, a soft, non-tender lump was palpated on the dorsum of Shahzaib’s left wrist. The lump was round, well-defined, and fluctuant. There was no redness, warmth, or signs of inflammation around the lump. The rest of the wrist and hand examination was unremarkable.

Sleep and 24-hour Pattern:

Shahzaib reported no disturbances in sleep due to the cyst. He noticed that the size of the lump sometimes varied over the course of the day.

Duration of Current Symptoms:

Symptoms had been present for approximately six months.

Mechanism of Injury/Current Symptoms:

Shahzaib attributed the appearance of the cyst to repetitive wrist movements associated with his job as an office manager. He experienced discomfort and occasional pain when the cyst was subjected to pressure or strain.

Progression Since the Current Episode:

The cyst had remained relatively stable in size over the past few months, with occasional fluctuations.

Significant Prior History:

Shahzaib had no significant prior history of similar lumps, injuries, or musculoskeletal issues.

Previous Treatment:

He had not sought any prior treatment for the cyst. He had tried occasional rest and over-the-counter pain relief when the pain was bothersome.

Diagnostic Test/Imaging:

Clinical evaluation and physical examination were sufficient to diagnose the ganglion cyst. No further imaging or diagnostic tests were deemed necessary.

Differential Diagnosis:

Ganglion Cyst

Lipoma

Tendon Sheath Tumor

Rheumatoid Arthritis Nodule

Postural Observation:

Shahzaib’s overall posture appeared normal, and there were no noticeable abnormalities in his wrist posture.

Precaution and Contraindications:

Avoiding excessive wrist strain and repetitive movements that might aggravate the cyst was recommended. No specific contraindications were noted.

Functional Movement Analysis (Sign):

Shahzaib demonstrated limited wrist flexion due to discomfort when flexing the wrist.

Quick Screening Tests/Clearing of Additional Joint Structures:

Quick screening tests did not reveal any issues with additional joint structures in the wrist.

Range of Motion (ROM):

Shahzaib had slightly reduced wrist flexion due to discomfort, but his overall wrist range of motion was within normal limits.

Special Tests:

Tinel’s sign was negative, ruling out involvement of the median nerve.

Assessment:

Shahzaib Malik presented with a ganglion cyst on the dorsum of his left wrist, causing mild discomfort and occasional pain. The cyst appeared to be related to repetitive wrist movements associated with his occupation as an office manager.

Problem List/Complaints:

Ganglion cyst on the dorsum of the left wrist

Mild discomfort and occasional pain

Concerns about appearance and functional limitations

Treatment:

Observation: Since the cyst was not causing significant functional limitations or severe pain, a conservative approach of observation was recommended.

Education: Shahzaib was educated about the nature of ganglion cysts, the benign nature of the condition, and the option for intervention if symptoms worsened.

Activity Modification: He was advised to avoid repetitive wrist movements that could aggravate the cyst.

Pain Management: Over-the-counter pain relievers were suggested for managing occasional discomfort.

Prognosis:

The prognosis for ganglion cysts is generally favorable. They are benign and can often remain stable or even spontaneously resolve. In cases where symptoms become more bothersome, various treatment options are available.

Goals:

Alleviate discomfort and occasional pain

Provide education and reassurance about the benign nature of the cyst

Prevent worsening of symptoms through activity modification

Interventions:

Observation and periodic follow-up

Education about the condition and its management

Pain management strategies

Encouragement of wrist protection during activities

Patient Education:

Shahzaib was educated about the following:

Ganglion cysts: definition, causes, and benign nature

Activity modification to avoid aggravation