RESUMO
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.
Assuntos
Anti-Inflamatórios/uso terapêutico , Cistos Glanglionares/terapia , Sucção/métodos , Cisto Sinovial/terapia , Triancinolona Acetonida/uso terapêutico , Articulação do Punho/cirurgia , Adolescente , Anti-Inflamatórios/administração & dosagem , Criança , Pré-Escolar , Terapia Combinada , Relação Dose-Resposta a Droga , Feminino , Cistos Glanglionares/tratamento farmacológico , Cistos Glanglionares/cirurgia , Humanos , Lactente , Injeções Intra-Articulares , Masculino , Recidiva , Esclerose , Cisto Sinovial/tratamento farmacológico , Cisto Sinovial/cirurgia , Resultado do Tratamento , Triancinolona Acetonida/administração & dosagem , Articulação do Punho/efeitos dos fármacos , Articulação do Punho/patologiaRESUMO
Los quistes sinoviales o ganglionares son estructuras originadas en la cápsula articular, de contenido mucinoso y conectados directamente a articulaciones o vainas sinoviales, siendo los tumores de partes blandas más frecuentes de mano y muñeca. Se han postulado muchas hipótesis respecto a su patogénesis considerándoseles principalmente como: protusiones de la sinovial, neoplasias benignas o lesiones degenerativas del tejido conectivo. Su ubicación más frecuente es el dorso de muñeca (ganglión originado en el ligamento escafolunato). La mayoría son asintomáticos y los pacientes consultan principalmente por razones de orden estético. Sin embargo, pueden producir dolor, sensación de debilidad o parestesias. El tratamiento puede ser conservador (observación en espera de regresión espontánea, aspiración, radioterapia, inyección de corticoides o de esclerosantes), pero lo más usado y efectivo continúa siendo la cirugía, que incluye excisión, sutura con punto transfixiante o resección artroscópica