The dorsal radiocarpal recess is the dorsal extension of the radiocarpal synovial space between the dorsal radius and the proximal row of carpal bones, beneath the dorsal radiocarpal ligament and the extensor tendon compartments. The scapholunate ligament dorsal aspect is accessible from within this recess. The dorsal recess is the primary site where dorsal wrist ganglia form, typically originating from the scapholunate joint.
The dorsal radiocarpal recess is the target for radiocarpal joint injection, performed from the 3-4 portal position between the third and fourth extensor compartments just ulnar to Lister tubercle. Dorsal wrist ganglia arising from the scapholunate ligament have their stalk within this recess and require complete stalk excision to the scapholunate joint to prevent recurrence. Arthroscopic assessment from the 3-4 portal provides the best view of the dorsal scapholunate ligament, the dorsal radiocarpal ligament, and the proximal carpal row cartilage.
A dorsal wrist ganglion arises from the scapholunate ligament through a stalk that protrudes into the dorsal radiocarpal recess and then through the capsule to the skin surface, producing a firm painless or mildly tender mass; treated by aspiration for temporary relief or arthroscopic excision of the full stalk for definitive management.
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