What is the role of imaging studies in the evaluation of digital mucous cysts (DMCs)?

Updated: Jul 31, 2018
  • Author: Murad Alam, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

Plain radiography findings are not diagnostic for digital mucous cysts (DMCs) but will demonstrate a nonspecific soft-tissue density and adjacent bony involvement consistent with osteoarthritic changes.

Ultrasonography evaluation reveals a rounded or lobulated mass of markedly hypoechoic appearance with smooth, well-defined walls immediately adjacent to the involved synovial compartment. A tapering margin, which constitutes the "neck" of the cyst, is observed. Ultrasound is faster and better tolerated than MRI, but MRI is less operator dependent.

CT scanning usually demonstrates a well-defined water density mass with normal surrounding soft tissue.

On MRIs, homogenous low-intensity lesions are seen on T1-weighted images, with markedly increased signal and sharp borders on T2-weighted images. Other cyst features that may be observed are intracystic septa, satellite cysts, cyst pedicles, osteoarthritis of the distal interphalangeal (DIP) joint, subungual cysts, and multiple flattened cysts. MRI is an excellent modality for visualizing soft tissue cyst structures and may be particularly useful preoperatively. [6]


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