Ultrasound guided injection of resistant extra-articular shoulder and elbow cysts in rheumatoid arthritis: A case report.

Abstract

A 26-year-old female who had been diagnosed with rheumatoid arthritis (RA) 5 years previously, developed multiple extra-articular cysts on shoulder and elbow. She referred to Physical Medicine and Rehabilitation department for musculoskeletal ultrasound guided intervention. RA cysts were resistance to previous blind injections and surgical resection. She had anterior shoulder and elbow pain and hand paresthesia. The average diameters of the cysts in sonography were 3 cm. The patient was keen to treat the cysts on her right shoulder and elbow as it hampered her activity of daily livings. However, it resisted previous interventions, when symptoms grew further we performed ultrasound guided injection of cysts with Triamcinolone. The symptoms were relieved, and the cysts were resolved completely in 12 month follow up sonographic investigations.