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Although it isn’t clear exactly what the cause of a synovial cysts is, it is generally accepted that they are related to the development of facet joint degeneration. This theory is thought to be most accurate because of the proximity of the cyst to the degenerated joint. Patients suffering from rheumatoid arthritis have also been observed with synovial cysts.
It is predicted that there is a large number of people carrying facet cysts and are not aware of it because they are asymptomatic (present but show no symptoms). This makes it near impossible to figure out the actual number of facet cyst incidences.
How to aspirate a facet joint
In simple terms a facet joint aspiration is the process of removing fluid from a facet joint. A facet joint aspiration is performed with the use of anesthesia in an office or hospital setting. The process begins with a thorough cleaning of the skin where the needle will enter the joint for aspiration. Once the needle is in place, the fluid from the joint is collected and tests can be performed on it to obtain an accurate diagnosis.
The reason for facet joint aspiration
There are two main reasons for facet joint aspiration
- Diagnostic - Fluid that is obtained from a facet cyst through the aspiration diagnostic procedure is sent to a lab and analyzed for things such as, cell count, crystal analysis, and culture.
- Therapeutic - Draining a synovial cyst will often provided pain relief along with an increase in the patients mobility. Quite often a anti-inflammatory medicine or a local anesthetic is injected along side the aspiration to help provide some extra relief to the symptoms
Joint aspiration risks
Although rare, the following side effects are the most common risks involved with facet joint aspiration
- Allergic reaction - The reaction may be triggered by the medicine injected, the tape that is used, and even the betadine used to clean the skin prior to the injection
- Infection - About one in fifteen thousand injections will result in some form of a minor infection
- Post injection flare - This term is used to describe the rare joint swelling that may occur occasionally after a corticosteroid injection. This occurs in about one in fifty injections and usually takes several days to subside
- De-pigmentation - Where the skin loses its color and starts to whiten
- Fat atrophy - Fat atrophy thins the skin
- Tendon rupture - A miss-guided needle could rupture a tendon
Although many are unsure, it is suspected that frequent corticosteroid injections may damage the joint and for this reason numerous facet joint injections are often discouraged.