Aspiration and Injection of Wrist Ganglia


OVERVIEW

 

INDICATIONS
  • Symptomatic ganglia over the wrist (or other non-weight-bearing joints)
  • Ganglia for which patients select nonsurgical intervention
CONTRAINDICATIONS
  • Uncooperative patients
  • Ganglia overlying artificial joints
  • Coagulopathy or bleeding diathesis
  • Presence of septic arthritis or bacteremia
TECHNIQUE
A large ganglion is depicted on the dorsum of the wrist.



Enter the ganglion from the side (horizontally) using a 16- or 18-gauge, 1-inch needle.
The needle is cross-clamped near its base with a straight hemostat .
After the aspirating syringe fills with the thick gel-like contents, the hemostat is used to stabilize the needle.
The aspirating syringe is removed, and the injecting syringe that contains corticosteroid is attached to the needle.
The steroid-lidocaine solution (e.g., 0.4 mL of Celestone and 1.6 mL of 1% lidocaine) is injected into the ganglion, and the cyst enlarges with the fluid.

 

Splinting or compression is advocated by many physicians after aspiration and injection. An ace wrap can be used over the site