Julie is a 60-year-old woman with a 25-year history of a slowly enlarging painless swelling of the left wrist.

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<p>Julie is a 60-year-old woman with a 25-year history of a slowly enlarging painless swelling of the left wrist.</p><p>The mass is soft, compressible and slightly purple. It disappears completely when the arm is elevated overhead and refills on dependency. There is no history of trauma or injury.</p><p>Julie is otherwise well, with no past history of note and no other similar masses. On examination, vital signs are within normal limits.</p><p>There is a 3cm x 2.5cm mass on the left anterior wrist (pictured), with no associated bruit, thrill or palpable pulsation.</p><p>The mass does not transilluminate and resolves with elevation of the arm above the level of the heart.</p>

Dr Kate Kelso is a GP and medical editor at Australian Doctor.