From the Research
Treatment for a cyst on the dorsal PIP joint should prioritize surgical excision as the definitive treatment, involving removal of the cyst along with any underlying joint capsule abnormality or osteophyte, as it provides the most effective and long-lasting results, reducing the risk of recurrence and complications, as seen in the most recent and highest quality study 1.
Overview of Treatment Options
- Conservative measures, such as observation and aspiration with a sterile needle, can provide temporary relief for symptomatic cysts, but recurrence is common.
- Intralesional corticosteroid injection (such as triamcinolone 10-40 mg/mL) may reduce inflammation and cyst size, but its effectiveness is limited compared to surgical excision.
Surgical Excision
- Surgical excision is the most effective treatment for cysts on the dorsal PIP joint, as it involves removal of the cyst along with any underlying joint capsule abnormality or osteophyte, reducing the risk of recurrence and complications, as seen in the study by 1.
- The study by 1 found that osteophyte excision and joint debridement can avoid skin necrosis caused by cyst removal and reduce the recurrence of cysts, making it a safe and effective treatment option.
Postoperative Care
- During recovery, elevation and ice can help reduce swelling, and gentle range of motion exercises should begin shortly after surgery to prevent stiffness.
- Patients should be aware that untreated cysts may occasionally cause nail deformities or joint stiffness, and rarely become infected, as seen in the study by 2.