Ultrasound-guided injection of ganglia with coricosteroids

Objective. The aim of this study was to demonstrate the use of ultrasound guidance in confirming intralesional injection of corticosteroids and local anesthetic into symptomatic ganglia, and to propose potential advantages of this technique. Design and patients. Ten patients (five men, five women) underwent ultrasound-guided injection of a ganglion. Seven ganglia were near the wrist, one was adjacent to a finger interphalangeal joint-and two were adjacent to the talus. All were injected with a 1:1 mixture of long-acting corticosteroid and local anesthetic, the actual volume being dependent on the size of the ganglion. Three patients had a second injection 9-18 months following the initial injection. Results. In four patients the ganglia resolved completely, In five patients there was significant improvement, with a reduction in size of the ganglion and symptomatic relief. Conclusion. Ultrasound-guided injection insures intralesional deposition of corticosteroids and may provide an alternative to surgery in the management of ganglia.