steroid ster·oid (stěr'oid', stēr'-)
Any of numerous naturally occurring or synthetic fat-soluble organic compounds having as a basis 17 carbon atoms arranged in four rings and including the sterols and bile acids, adrenocortical and sex hormones, certain natural drugs such as digitalis compounds, and the precursors of certain vitamins. Also called steroid hormone . adj. ste·roid·al (stĭ-roid', stě-)
Relating to or characteristic of steroids or steroid hormones.
This is a classic presentation of a mucous cyst. The most appropriate treatment would be excision of the cyst and removal of the underlying bone spur.
A mucous cyst of the hand is usually a small, soft, benign structure. They are associated with osteoarthritis and develop around bone spurs near a joint. Surgery is typically recommended if there is significant pain at the site of the cyst or with range of motion of the involved joint. Nail bed deformity may occur with disease progression if left untreated.
Rizzo et al. examined a series of 132 patients with mucous cysts, comparing outcomes between injection and surgery. They found that 60% of people with aspiration and steroid injection had complete resolution of the cyst compared to 100% with excision.
Figure A shows a small mucous cyst just proximal to the nailbed. Figure B shows a radiograph of the distal interphalangeal joint. There is extensive joint arthritis with dorsal bone spurs.
Answer A: Pain from a mucous cyst is usually constant, but in some people it may come and go. Rarely the cysts will resolve over time. Typically, the mucous cyst will progress with time and cause nail deformity.
Answer B: Aspiration will lead to a > 40% recurrence.
Answer C: Removal of cyst and joint fusion would be indicated if there was pain with with any forcible movement of the joint.
Answer E: Infection is usually not associated with a benign mucous cyst.