Peritendinous Mass
ESSENTIAL INFORMATION
Key Differential Diagnosis Issues
Only some tendons, notably those around wrist and ankle, have tendon sheaths
Some tendon areas, such as patellar and Achilles tendons, have incomplete tendon sheaths known as paratenon
Some tendon areas, such as extensor tendons at fingers and flexor capri ulnaris tendon, do not have tendon sheath
Tenosynovitis and giant cell tumor of tendon sheath can only occur in tendon with tendon sheath or paratenon
Helpful Clues for Common Diagnoses
Filled with gelatinous-type material of variable consistency
Anechoic, cystic-like structure closely related to joint
Usually originates from joint and extends to peritendinous location
If originating from tendon sheath, has no extension to adjacent joint
± comet-tail artifacts within cyst due to colloid aggregates
± leakage of or hemorrhage within cyst
Composed of multinucleated cells and fibroblast-like cells that may have hemosiderin deposits
Occurs mainly in hand, wrist, and foot
All giant cell tumors contact or partially encase tendon
Hypoechoic tumor, which may be irregular, fusiform, or rounded in outline
Usually moderately vascular, though, infrequently no demonstrable flow on color Doppler imaging
May be multifocal
High recurrence rate
Can mimic ganglion cyst
Inflammation or infection of tendon sheath with secondary inflammation of tendon
Acute exudative tenosynovitis
Acute nonexudative tenosynovitis
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