Purpose
The purpose of this study was to examine recurrence rates in patients referred to the radiology department for ultrasound-guided intervention of hand/wrist ganglions and to identify factors predictive of recurrence.
Methods and Materials
A retrospective review was performed on 124 patients.
Retrospective study of patients undergoing ultrasound-guided aspiration and/or corticosteroid injection (CSI) of hand/wrist ganglions over five-month period in 2014 ( the ultrasound aspiration with or without steroid injections) were performed at the radiology department by both junior and senior radiologists.
Data collected from patient record and telephone follow-up at minimum of 28-months.
Results
Referrals to unit n=124 ,
90 (72%) contactable for telephone follow- up.
Age range 2–100 years,
average 48.3 years; male-to-female ratio1:4.
Ganglion size range 0–80mm,
average 9.8 mm(SD 11.1mm); location 58(47% dorsal wrist ganglion).
No significant difference between follow up and non follow up
Fifty-four (60%)opted for intervention,(23 = aspirpiration,31=aspiration +CSI).
-36 (40%) declined.
Recurrence occurred in :
n= 30 patients (55%); 13 aspiration alone and 17 aspiration with CSI.
No reported complications.
There was no difference in gender predominance for recurrence.
Also there was...
Conclusion
Different treatments for wrist ganglia have been described and there is a variation of opinion on their etiology.
The treatments range from simple observation to aspiration with or without steroid injectionof various agents to arthroscopic resection and open excision.
Whilst patient age,
gender,
ganglion size or location did not prove to be useful in predicting recurrence of hand/wrist ganglia for ultrasound-guided interventions of either variety,
we have confirmed it is safe and effective,
with a minimal complication profile.
We recommend offering ultrasound guided interventional procedures...
References
1.
Angelides AC.
Ganglions of the hand andwrist.
In: Green DP (Ed).
Green's Operative
Hand Surgery.
Vol 2.
4th ed.
New York.
Churchill Livingstone,
1998;2171-83.
2.
McEvedy BV.
The simple ganglion: a review of modes of treatment and an explanation of the frequent failures of surgery.
Lancet 1954:16; 266:135-6.
3.
Nelson CL,
Sawmiller S,
Phalen GS.
Ganglions of the wrist and hand.
J Bone Joint Surg Am 1972; 5:1459-64.
4.
Surjit Lidder,
Vijai Ranawat,
Philip Ahrens.
Surgical excision of wrist
ganglia; literature review and nine-year...
Personal Information
Dr Sofia Vrizidou ,
MSc,
MSK Fellow Chelsea and Westminster Hospital (2016),
London UK .
Dr Ben Roberton,
MSK/IR consultant,
Chelsea and Westminster Hospital,
London UK.
Mr Gordon McArthur,
consultant- Plastic and Reconstructive SurgeryChelsea and Westminster Hospital ,
London UK.
Miss Anita Jatan FRCS (Plast),
MSc,Senior Clinical Fellow Plastic and Reconstructive Surgery,Chelsea and Westminster Hospital,
London UK.