Painless ganglion cyst aspiration for patient and clinician

Abstract

The management options for ganglion cysts include: observation, aspiration ± injection with steroid and surgical excision. One of the problems encountered during fine needle aspiration is the highly viscous cyst fluid being difficult to withdraw. We propose a modified technique, which improves the ease and speed of achieving complete aspiration of ganglion cysts by using local anaesthetic. Twenty-five patients who were referred from primary care and orthopaedic outpatients were diagnosed with ganglion cysts on ultrasound. The modified aspiration technique involves injecting a small volume of local anaesthetic into the cyst fluid prior to aspiration and was performed on all patients. All cysts were completely drained using this modified technique with no immediate complications and with minimal discomfort to the patient. Our adaptation to the technique of simple aspiration provides a method of achieving complete ganglion resolution with ease and in a time frame appropriate for a standard outpatient appointment. Low immediate complication rates are seen due to the adjunct of ultrasound and the local anaesthetic reduces patient discomfort during the procedure. This method has been particularly effective for large ganglions but can be equally effective for treating smaller lesions.