High School

A 29-year-old female presents with a "bump" on her wrist for the past week. She denies any pain or history of trauma. Her past medical history is unremarkable. On physical examination, you discover a 2.0 cm nontender, firm cystic lesion on the dorsum of the wrist.

What is the most likely diagnosis?

A. Squamous cell carcinoma
B. De Quervain tenosynovitis
C. Osteosarcoma
D. Ganglion cyst
E. Gout

Answer :

Final answer:

The described clinical scenario of a nontender, cystic lesion on the dorsum of the wrist without a history of trauma or pain most likely indicates a ganglion cyst.

Explanation:

The clinical presentation of a nontender, firm cystic lesion on the dorsum of the wrist in a 29-year-old female, with no pain or history of trauma, strongly suggests the diagnosis of ganglion cyst. Ganglion cysts are the most common mass or lump in the hand. They are typically located on the wrist and are filled with a jelly-like fluid. Key characteristics that support this diagnosis include their usual occurrence on the dorsum of the wrist, their firm and cystic nature, and the lack of pain associated with these cysts.

Other options, such as Squamous cell carcinoma, De Quervain tenosynovitis, Osteosarcoma, and Gout, are less likely given the described features of the lesion. For example, squamous cell carcinoma would likely have a different clinical presentation including potential pain and skin changes, De Quervain tenosynovitis would elicit pain upon certain movements, osteosarcoma is a type of bone cancer with distinct radiographic findings, and gout typically presents with acute, painful episodes of joint inflammation.