Stabilize the joint associated with myxoid cyst prior to surgical procedureMedical University of Ohio at Toledo
Craig G Burkhart MD MPH
Dermatology Online Journal 11 (3): 9
Myxoid cysts are outpouchings of the distal interphalangeal joint space often associated with minor osteoarthritic changes . Other names for this entity include digital mucous pseudocyts, ganglion of the distal interphalangeal joint, digital synovial cyst, and digital mucous cyst.
The cysts appear skin-colored to red to bluish in color and drain clear gelatinous material if punctured. Common treatments include intralesional injection of corticosteroids, repeated puncture and drainage, liquid nitrogen, surgical excision, and ligature of the connection to the joint capsule .
A simple medical treatment can prove curative by itself, or can improve the success rates of liquid nitrogen or injection. The procedure is partial immobilization of the joint with a plastic finger splint obtained by one of the various medical supply houses. In short, one advises the patient to wear the joint splint for at least 8 hours a day, especially during times in which the joint would normally be bent considerably (such as with writing, lifting weights, and yard work). Routinely, the cyst reduces in size within 2 days and a smaller splint is needed as slight compression of the myxoid cyst is beneficial, similar to treatment of ganglion cysts .
If the myxoid cyst is not calcified and not associated with significant joint pathology, this simple partial immobilization is often curative within 4 weeks. In cases in which the swelling returns after compression and stabilization, liquid nitrogen and intralesional steroid injection are helpful, especially if these procedures are performed once the cyst is minimized in size. Of note, total immobilization can cause joint fixation and is not advisable.
References1. de Berker D, Lawrence C. Ganglion of the distal interphalangeal joint (myxoid cyst): therapy by identification and repair of the leak of joint fluid. Arch Dermatol. 2001 May;137(5):607-10. PubMed.
2. De Berker DA, Lawrence CM. Treatment of myxoid cysts. Dermatol Surg. 2001 Mar;27(3):296-9. PubMed
3. Soren A. Clinical and pathological characteristics and treatment of ganglia. Contemporary Orthopedics 1995;31:34-8.
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