What is a synovial cyst?
Synovial cyst is one of the most common benign subcutaneous formations, with multiple locations but most often found in the radiocarpal joint (dorsal face of the wrist).A rarer location is the joints in the foot.The cyst has a soft, semi-solid consistency on palpation and contains synovial fluid (clear fluid that comes from the joints) and is covered by connective tissue. The formation is mobile to the touch on the skin but is deeply adherent.
What are the causes of synovial cyst?
Among the causes of the appearance of synovial cysts are:
• certain activities that overload the joints of the hand
• hyperlaxity of the ligaments
• repeated trauma
• may occur spontaneously without having a specific cause
Symptoms vary depending on the location and size of the synovial cyst. These include deformity of the area where the synovial cyst is located, pain that can sometimes radiate to the hand or forearm, hypoaesthesia and paresthesia when the cyst compresses certain nerve branches, and symptoms can lead to decreased muscle strength and functional impotence in cysts. large size.
The diagnosis is established after consultation based on a thorough clinical examination of the hand. Sometimes additional investigations may be needed: soft tissue ultrasound, x-ray or MRI.
Treatment of synovial cyst
The treatment is established after the consultation and depends on the symptoms, the stage at which it is find out about the cyst and any associated diseases.
For small cysts, it is recommended to monitor them, avoid local traumas, rest the joint and use a special orthosis for a period of time to protect the area. If there is pain, an anti-inflammatory treatment can be combined.
Another variant of treatment would be the aspiration of the cyst, ie the extraction of synovial fluid by puncture. It is a painless treatment, but with the risk of cyst recurrence because the lining of the synovial cyst remains intact and the joint gap is not ligated.
If the above treatments do not work, surgical excision of the cyst is recommended. The procedure is performed under local anesthesia and consists in the complete resection of the cyst and the closure of the joint gap, thus reducing the risk of recurrence of the cyst.
• it is recommended to use an orthosis / splint for 14-21 days
• anti-inflammatory treatment, analgesics in case of pain or postoperative discomfort
• when the patient tolerates the movements, physiokinetotherapy is started
• the sutures will be removed at 14 days
• cold compresses, gels, ice are used to reduce the edema of the operated area
• avoiding local traumas
Recovery from the excision of a synovial cyst depends on the size of the cyst, its symptoms and the physiokinetotherapy program followed
Complications that may occur following surgical excision of a synovial cyst are the following:
• bleeding - people who use anticoagulant treatment have a higher risk
• neuromas - in case of sectioning of a nerve
• damage to arterial branches
• recurrence of synovial cyst - the risk of recurrence is higher in case of cyst aspiration