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Related Experiment Video

Updated: Sep 10, 2025

Author Spotlight: Ultrasound-Guided Needle Release Combined with Corticosteroid Injection for the Treatment of Supinator Syndrome
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Ganglion Formation After Steroid Injection for Stenosing Flexor Tenosynovitis.

Kazuhiro Kohata1, Yutaka Morizaki1,2, Takafumi Miyake1

  • 1Department of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan.

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|August 25, 2025
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Summary

Steroid injections for stenosing tenosynovitis may increase the risk of developing flexor tendon sheath ganglions (FTSG). While injections provide symptom relief, they are linked to a higher FTSG incidence compared to non-injection treatment.

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Area of Science:

  • Orthopedics
  • Hand Surgery
  • Musculoskeletal Imaging

Background:

  • The precise mechanism of flexor tendon sheath ganglion (FTSG) formation is not fully understood.
  • Steroid injections into the A1 pulley are a suspected etiological factor for FTSG.
  • This study investigates the association between steroid injections and FTSG development in patients with stenosing flexor tenosynovitis.

Purpose of the Study:

  • To evaluate the risk of flexor tendon sheath ganglion (FTSG) formation following corticosteroid injections.
  • To compare the incidence of FTSG in patients receiving steroid injections versus those not receiving injections for stenosing flexor tenosynovitis.

Main Methods:

  • A prospective cohort study included 114 patients with stenosing flexor tenosynovitis.
  • Participants underwent initial ultrasound; those with pre-existing FTSG were excluded.
  • The injection group received a steroid injection into the flexor tendon sheath, while the control group did not; both groups were followed with ultrasounds at 3 months.

Main Results:

  • The incidence of FTSG was significantly higher in the steroid injection group (37.7%) compared to the control group (4.5%).
  • A significant risk difference (0.33) was observed between the groups (p < 0.01).
  • Symptom improvement was significantly greater in the injection group (93%) versus the control group (45%) (p < 0.01).

Conclusions:

  • Steroid injections, potentially due to micro-punctures, may contribute to the formation of flexor tendon sheath ganglions.
  • While injections offer superior symptom relief for stenosing flexor tenosynovitis, their role in FTSG development warrants further investigation.
  • The clinical significance of steroid injection-induced ganglion formation requires additional study.