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Semin Musculoskelet Radiol 2025; 29(06): 871-881
DOI: 10.1055/s-0045-1811531
Review Article

Cystic Lesions of the Hand Skeleton

Authors

  • Paul Reidler

    1   Department of Radiology, University Hospital, LMU Munich, Munich, Germany

  • Rainer Schmitt

    1   Department of Radiology, University Hospital, LMU Munich, Munich, Germany
    2   Department of Radiology, University Hospital Wuerzburg, Wuerzburg, Germany

  • Alexander Klein

    3   Orthopaedic Oncology, Department of Orthopedics and Trauma Surgery, University Hospital, LMU Munich, Munich, Germany

  • Elisabeth Haas-Lützenberger

    4   Department of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Munich, Germany

  • Nina Hesse

    1   Department of Radiology, University Hospital, LMU Munich, Munich, Germany

  • Boj F. Hoppe

    1   Department of Radiology, University Hospital, LMU Munich, Munich, Germany
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Abstract

Cystic bone lesions of the hand encompass a heterogeneous group of entities presenting as mostly well-defined lytic areas on imaging. The most common entities are ganglion cysts and degenerative geodes, typically arising adjacent to joints in adults. Primary masses include simple (unicameral) and aneurysmatic bone cysts. Also, other benign tumors like enchondroma, epidermoid inclusion cyst, giant cell tumor, fibrous dysplasia, tenosynovial giant cell tumor, and brown tumor can appear as expansile lucent lesions. Inflammatory processes such as rheumatoid arthritis or gout often produce focal osteolytic defects resembling cystic cavities.

Multimodal imaging is often necessary. Magnetic resonance imaging is useful to detect cystic defects and assess adjacent soft tissues; computed tomography can depict cortical integrity. Radiography is especially helpful to assess aggressiveness of growth and for follow-up. Management depends on symptoms and etiology. Most true cystic lesions are usually treated conservatively. Other symptomatic or aggressive lesions may require curettage, bone grafting, or targeted therapy.

Keywords

hand imaging - bone tumors - intraosseous cysts - cystic lesions


Publication History

Article published online:
03 December 2025

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