Synovialcesysin children: clinical features, diagnostics, treatment (analytical review of the literature and own observation).

Abstract

Background. Synovial cysts are structurally mucinous pseudotumors that usually arise from the underlying joint capsule, bursa, tendon sheath, or subchondral bone. Synovial cysts in children are a problem that occurs in different parts of the world, but their prevalence is characterized by significant fluctuations depending on the type of formation and its localization. Ganglion cysts of the wrist, for example, are the most frequently diagnosed benign soft tissue neoplasms in children in the United States and Western European countries, where they account for a significant proportion of the total number of cases. At the same time, this figure is somewhat lower in Asian countries, which may be due to various factors, including genetic predisposition and lifestyle characteristics.Purpose – to draw the attention of the medical community to the specifics of the clinic, diagnosis and treatment of synovial cysts in children, to demonstrate their own experience in a clinical case.Materials and Methods. The results of scientific research for 1998–2025 were analyzed and summarized, selected based on an information search in the scientometric databases Scopus, Web of Science, PubMed, MEDLINE, Google Scholar using the keywords «synovial cyst», «Beckeʼs cyst», «hygroma», «children», «surgical treatment». The largest number of articles was represented by clinical studies and presentations of clinical cases – 74%, data from literature sources containing literature reviews were also obtained for the literature review – 26%. Results. Therefore, the exact frequency of hygromas among children is currently unknown. Thus, according to literature sources, the frequency of pathology in patients under 20 years of age reaches 10% in the population and less than 2% in children under 10 years of age. However, the frequency of hygromas may actually be much higher, due to a certain underestimation of cases when the presence of pathology was not accompanied by impaired function and pain. The etiology of hygromas in children is multifactorial and includes both congenital and acquired factors. The main ones are traumatic injuries, infectious and inflammatory processes, genetic abnormalities and age-related developmental characteristics. For timely detection and effective treatment, it is important to take these factors into account. This allows you to significantly improve the quality of life of children and avoid the development of complications such as mobility restrictions and chronic pain. A comprehensive approach to diagnosing pathology allows you to not only accurately establish a diagnosis, but also choose the optimal treatment tactics, which is of great importance for improving the patientʼs quality of life. Usually, the diagnosis of synovial cysts does not cause difficulties, but it is important to conduct a differential diagnosis to exclude other pathologies that have a similar clinical picture. This allows you to choose the right treatment methods.Conclusions. Synovial cysts in children are benign formations that arise as a result of the accumulation of synovial fluid in a limited cavity surrounded by a connective tissue capsule. The etiology includes congenital joint dysplasia, trauma, inflammatory processes, mechanical overload and genetic predisposition. Differential diagnosis is based on the exclusion of ganglion cysts, tumors, vegetative lesions, osteoarthritic changes and congenital anomalies. A wide range of diagnostic methods, including clinical examination, ultrasound, MRI and, if necessary, puncture biopsy, allows rationally determining the treatment tactics, which in turn depends on the size of the cyst and clinical symptoms: conservative methods (physiotherapy, puncture with the introduction of anti-inflammatory drugs) or surgical removal are possible. However, when choosing a method for removing a cyst, it is necessary to choose the method that causes the least harm and makes relapse as unlikely as possible. Postoperative control and rehabilitation reduce the risk of relapse and complications