Short-and long-term results of ultrasound-guided fine-needle aspiration and steroid injection in the treatment of ganglion cysts

Year 2022, Volume: 5 Issue: 1, 269 - 273, 17.01.2022

Taha Yusuf Kuzan , Osman Yüksel Yavuz

https://doi.org/10.32322/jhsm.1002015

Abstract

Objective: To determine the efficacy and safety of percutaneous aspiration and steroid injection treatment for ganglion cysts and retrospectively evaluate the size change in ganglion cysts during follow-up.
Material and Method: All patients who underwent percutaneous aspiration and steroid injection treatment for ganglion cysts between January 2019 and February 2020 were included in the study. Demographic characteristics and clinical signs and findings of the patients were obtained from electronic patient records. Treatment response was classified as “excellent,” “good,” and “poor” at one month and one year according to ultrasound measurement.
Results: Ganglion cyst aspiration and steroid injection were successfully performed in 37 (86.0%) of 43 cases. A total of 28 cases with short- and long-term follow-ups were included in the final analysis. All the cases had cosmetic complaints before the treatment, and seven had pain and four had limited range of motion. Early treatment response was excellent in 7 (25.0%) patients, good in 14 (50.0%), and poor in 7 (50.0%). Late treatment response was excellent in 18 (64.3%) patients, good in 3 (10.7%), and poor in 7 (25.0%). After the procedure, mild pain lasting less than two days developed in the cyst area in half of the patients. Skin color change was observed in two cases in the first-month follow-up.
Conclusion: Ultrasound-guided fine-needle aspiration and steroid injection with the right technique is an alternative cost-effective method to surgery that can be successfully applied in the treatment of ganglion cysts with low side effects and relatively good results.

Keywords

ganglion, cyst, aspiration, steroid, injection

Supporting Institution

N/A

Project Number

N/A

References

• Jose J, Silverman E, Kaplan L. Symptomatic ganglion cyst of the popliteus tendon treated with ultrasound-guided aspiration and steroid injection: A case report. Sports Health 2011; 3: 393–5.
• Derman P, Kamath AF, Kelly Iv JD. Ganglion cysts of the posterior cruciate ligament. Am J Orthop (Belle Mead NJ) 2011; 40: 257–8.
• DeFriend DE, Schranz PJ, Silver DA. Ultrasound-guided aspiration of posterior cruciate ligament ganglion cysts. Skeletal Radiol 2001; 30: 411–4.
• Suen M, Fung B, Lung CP. Treatment of ganglion cysts. ISRN Orthop 2013; 2013: 940615.
• Gude W, Morelli V. Ganglion cysts of the wrist: pathophysiology, clinical picture, and management. Curr Rev Musculoskelet Med 2008; 1: 205–11.
• Varley GW, Needoff M, Davis TR, Clay NR. Conservative management of wrist ganglia. Aspiration versus steroid infiltration. J Hand Surg Br 1997; 22: 636–7.
• Breidahl WH, Adler RS. Ultrasound-guided injection of ganglia with coricosteroids. Skeletal Radiol 1996; 25: 635–8.
• Turgut MC, Toy S. Surgical outcomes regarding wrist ganglion cysts based on surgical experience. Erciyes Med J 2021. doi: 10.14744/etd.2021.38739
• Nahra ME, Bucchieri JS. Ganglion cysts and other tumor related conditions of the hand and wrist. Hand Clin 2004; 20: 249–60.
• Dias JJ, Dhukaram V, Kumar P. The natural history of untreated dorsal wrist ganglia and patient reported outcome 6 years after intervention. J Hand Surg Eur Vol 2007; 32: 502–8.
• Mackie IG, Howard CB, Wilkins P. The dangers of sclerotherapy in the treatment of ganglia. J Hand Surg Br 1984; 9: 181–4.
• Gümüş N. A new sclerotherapy technique for the wrist ganglion: Transcutaneous electrocauterization. Ann Plast Surg 2009; 63: 42–4.
• Becker WF. Hydrocortisone therapy in ganglia. Ind Med Surg 1953; 22: 555–7.
• Hussain S, Akhtar S, Aslam V, Khan SM. Efficacy of aspiration and steroid injection in treatment of ganglion cyst. Pakistan J Med Heal Sci 2015; 9: 1403–5.
• Kim JP, Seo JB, Park HG, Park YH. Arthroscopic excision of dorsal wrist ganglion: Factors related to recurrence and postoperative residual pain. Arthrosc - J Arthrosc Relat Surg 2013; 29: 1019–24.
• Gündeş H, Cirpici Y, Sarlak A, Müezzinoglu S. Prognosis of wrist ganglion operations. Acta Orthop Belg 2000; 66: 363–7.
• Rochlin DH, Perrault D, Sheckter CC, Fox P, Yao J. Prevalence of Ganglion Cyst Formation After Wrist Arthroscopy: A Retrospective Longitudinal Analysis of 2420 Patients. Hand 2020.
• Jagers Op Akkerhuis M, Van Der Heijden M, Brink PRG. Hyaluronidase versus surgical excision of ganglia: a prospective, randomized clinical trial. J Hand Surg Br 2002; 27: 256–8.
• Limpaphayom N, Wilairatana V. Randomized controlled trial between surgery and aspiration combined with methylprednisolone acetate injection plus wrist immobilization in the treatment of dorsal carpal ganglion. J Med Assoc Thai 2004; 87: 1513–7.
• Singhal R, Angmo N, Gupta S, Kumar V, Mehtani A. Ganglion cysts of the wrist : a prospective study of a simple outpatient management. Acta Orthop Belg 2005; 71: 528–34.
• Stapczynski JS. Localized depigmentation after steroid injection of a ganglion cyst on the hand. Ann Emerg Med 1991; 20: 807–9.
• Zhang S, Xu B, Lao Y, Lu D. The Treatment of wrist ganglion cyst by the Chinese acupotomy and crisscross thread. Res Sq 2021. doi: 10.21203/rs.3.rs-94895/v1.