Orthopedics Book

http://www.fpnotebook.com/

Ganglion Cyst Injection

Aka: Ganglion Cyst Injection, Ganglion Cyst Aspiration
  1. See Also
    1. Hand Injection
    2. Joint Injection
    3. Injectable Corticosteroid
  2. Indications
    1. Ganglion Cyst
  3. Preparation
    1. Needle: 18 to 22 gauge (1.5 inch)
    2. Anesthetic (in Syringe 1)
      1. Lidocaine 1%: 1-2 ml or
      2. Bupivacaine (Marcaine) 0.25% 1-2 ml
    3. Corticosteroid (in Syringe 2)
      1. Methylprednisolone: 20-40 mg or
      2. Celestone Soluspan: 1 ml or
      3. Triamcinolone 20-40 mg
    4. Other instruments
      1. Hemostat to hold needle while changing syringes
  4. Efficacy
    1. Aspiration alone as effective as aspiration + injection
    2. Recurrence rate after aspiration: 47%
    3. Dias (2003) J Hand Surg 28:172-6 [PubMed]
  5. Technique
    1. Joint position
      1. Hold joint in position that accentuates cyst
    2. Injection site
      1. Mark point of maximal cyst fluctuance
    3. Needle insertion and aspiration
      1. Apply antiseptic to skin (e.g. Betadine)
      2. Insert needle into cyst and aspirate fluid (1-2 cc)
    4. Corticosteroid Injection (questionable efficacy)
      1. Continued from needle insertion aspiration
      2. Consider not injecting Corticosteroid
        1. Not found to offer benefit over aspiration alone
      3. Apply hemostat to hold needle within cyst
      4. Replace anesthetic syringe with steroid syringe
      5. Inject Corticosteroid into cyst
    5. Needle removal and aspiration site care
      1. Remove needle and apply Bacitracin and bandage
      2. Apply ACE wrap over cyst site for 48 to 72 hours
  6. References
    1. Neustadt in Roberts (1998) Procedures, p. 912-13
    2. Pfenninger (1994) Procedures, Mosby, p. 1036-54
    3. Tallia (2003) Am Fam Physician 67(4):745-50 [PubMed]

You are currently viewing the original 'fpnotebook.com\legacy' version of this website. Internet Explorer 8.0 and older will automatically be redirected to this legacy version.

If you are using a modern web browser, you may instead navigate to the newer desktop version of fpnotebook. Another, mobile version is also available which should function on both newer and older web browsers.

Please Contact Me as you run across problems with any of these versions on the website.

Navigation Tree