Epidemiology of Symptomatic Dorsal Wrist Ganglia in Active Duty Military and Civilian Populations

Theodora C Dworak; George C Balazs; Jordan Tropf; George P Nanos 3rd; Scott M Tintle

doi:10.1016/j.jhsg.2020.08.001

Epidemiology of Symptomatic Dorsal Wrist Ganglia in Active Duty Military and Civilian Populations

J Hand Surg Glob Online. 2020 Sep 18;2(6):349-353. doi: 10.1016/j.jhsg.2020.08.001. eCollection 2020 Nov.

Authors

Theodora C Dworak^{1

2}, George C Balazs^{1

2}, Jordan Tropf¹, George P Nanos 3rd^{1

2}, Scott M Tintle^{1

2

3}

Affiliations

¹ Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, MD.
² Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD.
³ Department of Orthopaedic Surgery, University of Pennsylvania Health System, Philadelphia, PA.

Abstract

Purpose: The epidemiology of dorsal wrist ganglia (DWG) has been poorly studied. The purpose of this study was to determine the epidemiology of DWG in the US military and civilian populations. We hypothesized that military service would be associated with an increased risk for developing a DWG.

Methods: The US Department of Defense Management Analysis and Reporting Tool, a database of health care encounters by military personnel and dependents, was queried for encounters with an International Classification of Diseases, Ninth Revision diagnosis of 727.41 (ganglion of a joint) or 727.43 (ganglion, unspecified location) between 2009 and 2014. There is no specific code for DWG, so a random sample of 1,000 patients was selected from both the military and civilian cohorts. These 2,000 electronic medical records were examined to identify patients with a DWG. This estimate was used to determine the unadjusted incidence of DWG with a 95% confidence interval and a 5% margin of error in the entire military and civilian dependent population. Adjusted incidence rates and incidence rate ratios (IRR) were determined using Poisson regression, controlling for demographic covariates.

Results: The incidence of DWG in the military population is 14.25/10,000 person-years compared with 7.01/10,000 person-years in the civilian population. Female sex was a significant risk factor in both the military (IRR, 2.59) and civilian populations (IRR, 2.26). Younger age group (age 25-34 years) was a significant risk factor for DWG compared with an older age group (age 45-64 years) in both the military (IRR, 1.74) and civilian populations (IRR, 2.56). Senior rank (both officer and enlisted) was a significant risk factor for DWG compared with junior rank (IRR, 1.95).

Conclusions: The incidence of DWG was higher in the military compared with the civilian population. There is a higher incidence of a DWG in females and in the senior ranks (both officer and enlisted).

Type of study/level of evidence: Prognostic III.

Keywords: Dorsal wrist ganglia; Epidemiology; Hand mass.