Striking a dorsal wrist ganglion with
a large Bible to rupture the cyst was a treatment used for centuries.
Once the cyst ruptures, the body absorbs the fluid, and the lesion can
be cured in approximately a third of individuals. This “Bible
technique,” however, carried with it a high recurrence rate as
well as a significant risk of fracture and other injury to surrounding
tissues. Today, a more controlled technique of aspiration with or
without steroid injection has become the most commonly performed
nonsurgical intervention for ganglia. A large-bore needle is placed
within the ganglion to remove the thick, viscous fluid. Simple
aspiration is associated with high rates of recurrence
(>50%). Injection of corticosteroid after aspiration can
help to shrink or resolve the lesions and reduces recurrences to between
13% and 50%.