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July 1957

Hyaluronidase Therapy of Synovial Cysts

AMA Arch Derm. 1957;76(1):111-112. doi:10.1001/archderm.1957.01550190115026

Synovial cysts are cystic lesions which develop over the articulations of the interphalangeal, metacarpophalangeal, and metatarsophalangeal joints. When punctured, these lesions yield a yellowish or syrupy fluid. They are found most frequently in persons with osteoarthritis.1 Histologically, a synovial cyst is a cystic cavity in the dermis or subcutaneous tissue. The lining wall is made up of fibrous tissue without endothelial or epithelial lining.2 It is filled with mucoid material which is recognized to contain mucopolysaccharides, especially hyaluronic acid.

Hyaluronidase has been demonstrated to have mucolytic activity in various tissues including synovial fluid.3 Therefore it was reasoned that the injection of hyaluronidase into such cysts might result in dissolution of the mucoid contents with the disappearance or improvement of the cysts.

Report of Cases

Case 1.—A 47-year-old unmarried white woman was first seen March 16, 1955, because of a painless swelling of the left middle