Ultrasound-guided percutaneous treatment of volar radiocarpal ganglion cysts : safety and efficacy

Purpose: To determine the safety and efficacy of ultrasound (US)-guided percutaneous treatment of volar radiocarpal ganglion cysts. Methods: The institutional review board approved the retrospective study of patients referred for US-guided percutaneous treatment of a volar radiocarpal ganglion cyst over a 5-year period. Treatment consisted of a combination of aspiration, lavage using anesthetic, wall fenestration, and steroid injection. Intraprocedural imaging and procedure notes were reviewed. Followup information was retrieved from postprocedure electronic medical records. Results: Eighty-eight patients comprised our study group. Complete decompression of the ganglion cyst was achieved in 92% of cases immediately after treatment. There were no instances of hematoma or infection. Of 38 patients with available followup information, 66% had a ganglion cyst recurrence at a median time of 9 months, regardless of their initial size or the injection of steroids. Cysts with internal septa had a statistically significantly higher rate of recurrence (P = 0.033). Conclusions: US-guided percutaneous treatment of volar radiocarpal ganglion cysts is safe and ensures immediate decompression in most cases. However, cysts may recur, even after steroid injection or lavage.