Aspiration and triamcinolone acetonide injection of wrist synovial cysts in children

Purpose

The aim of this case series report is to assess the effectiveness of aspiration and injection of triamcinolone acetonide for treatment of wrist synovial cysts in children.

Methods

Twenty-one records of pediatric patients with synovial cyst on the wrist treated with aspiration and triamcinolone acetonide injection were selected for analysis of their outcomes. All cases were aspirated and injected at the operating room under mask induction anesthesia. Three categories were used to classify the patients' outcomes: (1) successful treatment with no recurrence, (2) successful treatment with residual sclerotic lump, and (3) recurrence of cyst.

Results

Fourteen females and 7 males with an average age of 7.2 years had a mean time with the cyst of 1 year. All children were asymptomatic. After aspiration, 13 (62%) of 21 patients experienced successful treatment of the synovial cyst with no recurrence after a single intervention. Five patients had a residual lump at the site of the cyst (24%), which disappeared after an average of 6 months. Three patients experienced true recurrence of the synovial cyst (14%). Average follow-up was 2.5 years.

Conclusions

Aspiration and injection of triamcinolone accounted for a considerable reduction in recurrence. Aspiration and triamcinolone acetonide injection of wrist synovial cysts is an effective and safe treatment that may be considered as first-line treatment in the pediatric population if there is no resolution after 1 year of observation.