Alternative and effective treatment of shoulder ganglion cyst: Ultrasonographically guided aspiration

The therapeutic effect of ultrasonographically guided aspiration of a gangl ion cyst of the shoulder is evaluated. Fifteen patients (nine male, six fem ale) with chronic shoulder pain were enrolled in this study. Each patient w as referred to rule out rotator cuff lesion. The ultrasonographic examinati on showed an anechoic cystic lesion in the shoulder region in every patient and abnormality of the rotator cuff in only four patients. Under ultrasono graphic guidance, an 18 gauge needle was inserted into the cyst to aspirate the fluid. Initial sonographic imaging showed the cyst, which appeared as a localized fluid accumulation and was located between the deltoid muscle a nd the subscapularis tendon in seven patients, between the deltoid muscle a nd the biceps tendon in one patient, below the coracoacromial ligament in f ive patients, and over suprascapular notch area in one patient. The ganglio n cysts ranged in size from 3.5 to 30 mm. The amount of aspirated fluid in each cyst varied from 0.4 to 12 ml (mean, 2.6 ml +/- 3.1) with a clear or l ight yellowish color and a jelly-like appearance. No major complications oc curred during or after this procedure. The symptom (pain) was improved afte r sonographically guided aspiration in each patient. Follow-up study showed complete relief of pain in four patients, marked improvement in nine patie nts, and mild improvement but still persistent shoulder pain in two patient s. Duration of followup study ranged from 2 to 24 months (mean, 6.4 months +/- 6.9). The success rate for sonographically guided aspiration was 86% on the basis of marked symptom Improvement or relief. Ultrasonographically gu ided aspiration of shoulder ganglion cysts is an effective procedure in the management of shoulder pain caused by ganglion cysts.