What is the role of wrist arthrocentesis in the management of ganglia?

Updated: Nov 03, 2020
  • Author: Richard S Krause, MD; Chief Editor: Erik D Schraga, MD  more...
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Answer

Small, often hard, nodular structures known as ganglia are frequently present around the hands and wrists, and they may occur in many other areas near joints or tendons. These structures usually contain a thick gelatinous substance that is difficult to aspirate. Although surgical excision may be generally preferable for treatment of wrist ganglia, wrist arthrocentesis and intra-articular steroid injection may be worthwhile options for some patients. [9, 10, 11]

In cases where pain, tendon dysfunction, or nerve entrapment symptoms are bothersome to the patient, aspiration may be attempted, usually with an 18- to 20-gauge needle. Even if no fluid is obtained, the process of puncture occasionally causes the structure to dissipate its contents, and symptoms are relieved. A small amount (0.2-0.5 mL) of steroid with lidocaine may be injected in an attempt to prevent reaccumulation of fluid.


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