From the Guidelines
Aspiration and injection for a dorsal wrist ganglion cyst is a moderately effective treatment option, but its effectiveness is not directly addressed in the provided evidence. The provided evidence 1 focuses on the appropriateness of imaging examinations for patients with chronic wrist pain, rather than the treatment of dorsal wrist ganglion cysts. However, based on general medical knowledge, aspiration and injection can provide temporary relief for patients with dorsal wrist ganglion cysts. Some key points to consider when performing this procedure include:
- Using an 18-20 gauge needle for aspiration after local anesthesia with 1-2 mL of 1% lidocaine
- Injecting corticosteroid, typically 20-40 mg of methylprednisolone or triamcinolone, to reduce inflammation
- Informing patients about potential side effects, such as pain during the procedure, skin discoloration, and the possibility of incomplete drainage
- Considering multiple aspirations to improve success rates
- Weighing the benefits of this less invasive approach against the lower recurrence rate of surgical excision, which carries surgical risks. It is essential to note that the effectiveness of aspiration and injection for dorsal wrist ganglion cysts is not explicitly stated in the provided evidence 1, and the decision to use this treatment should be based on individual patient needs and preferences.
From the Research
Effectiveness of Aspiration and Injection for Dorsal Wrist Ganglion Cyst
- The effectiveness of aspiration and injection for dorsal wrist ganglion cysts has been studied in several research papers 2, 3, 4, 5, 6.
- A study published in the Journal of hand and microsurgery in 2011 found that the success rate of aspiration combined with intralesional triamcinolone acetonide injection plus wrist immobilization was 61.1%, which was lower than the success rate of surgical excision (94.4%) 2.
- Another study published in Scientific reports in 2025 also found that surgical excision had a higher success rate (92.5%) compared to aspiration and injection (64.3%) 3.
- However, a study published in the World journal of plastic surgery in 2019 found that aspiration followed by intralesional steroid injection had a higher success rate (86.8%) compared to surgical excision (83.3%) 4.
- A prospective observational study published in the Journal of clinical orthopaedics and trauma in 2021 found that a combination of aspiration, steroid instillation, and tranfixation with silk suture had a success rate of 95.2% with only 4 recurrences 5.
- A retrospective study published in Orthopaedics & traumatology, surgery & research in 2022 found that corticosteroid injections had a recurrence rate of 73.2% and did not appear to be effective in treating dorsal ganglion cysts of the wrist 6.
Comparison of Treatment Options
- The studies suggest that surgical excision may be a more effective treatment option for dorsal wrist ganglion cysts, with higher success rates and lower recurrence rates compared to aspiration and injection 2, 3.
- However, aspiration and injection may still be a viable treatment option, especially for patients who prefer a less invasive procedure or have a high risk of surgical complications 4, 5.
- The effectiveness of corticosteroid injections is still unclear, with some studies suggesting that they may not be effective in treating dorsal ganglion cysts of the wrist 6.
Recurrence Rates
- The recurrence rates for aspiration and injection vary widely, ranging from 35.7% to 73.2% 3, 6.
- Surgical excision appears to have lower recurrence rates, ranging from 7.5% to 15% 2, 3.
- The combination of aspiration, steroid instillation, and tranfixation with silk suture had a recurrence rate of only 4.8% 5.