Which preoperative tests are performed to facilitate removal of digital mucous cysts (DMCs)?

Updated: Jul 31, 2018
  • Author: Murad Alam, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

Transillumination with a penlight may assist in making the diagnosis and in differentiating digital mucous cysts from giant-cell tendon sheath tumor.

Approximately 12 hours before surgery, the DIP joint may be injected with methylene blue and local anesthetic. The coloring of the entire cyst and pedicle at the time of surgery may facilitate removal of the entire cyst and minimize the risk of recurrence.

Injection of radio-opaque contrast material into the cyst and passage of this material into the adjacent joint may yield a radiograph that reveals the entire extent of the cyst. This technique provides an image of the cyst extent prior to the surgery itself; therefore, it may be more practical than methylene blue infusion. [7]

Chemical analysis of matrix is a research test that has no role in routine diagnosis. Cellulose acetate paper electrophoresis and enzymatic digestion liquid chromatography demonstrates that digital mucous cysts contain copious quantities of glycosaminoglycans, primarily hyaluronic acid.


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