Bluish, Tender Nodule on the Finger

M. Shane Chapman, MD

Disclosures

December 03, 2001

Treatment

Digital mucous cysts are histologically benign and do not need to be removed. However, if they become painful patients may opt for removal.

There are several approaches to the removal of these cysts,[3] but treatment is not successful in all cases. Many patients report recurrences no matter what therapy is chosen.

One approach is to repeatedly puncture the cyst,[4] which causes extrusion of the viscous material inside the cyst or pseudocyst. Intralesional steroids after draining the cyst have also been used with varying results. The base of the lesion may be curetted and/or fulgurated. Because of the potential connection with the joint space, all these methods carry a risk of local tissue or joint infection.

Other reported treatments include injection of a sclerosant,[5] carbon dioxide laser treatment,[6] and cryosurgery.[7,8]

Another option is to surgically excise the cyst and stalk (if present),[9,10] but this procedure also carries the risk of infection and recurrence. If an individual cyst continues to recur after multiple attempts at removal, referral to a hand surgeon for removal of the synovial lining and all osteophytes may be indicated as a last resort.

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