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Chalidis BE, Sachinis NC, Dimitriou CG. Ulnar nerve penetration by a volar ganglion in the Guyon canal. Plast Reconstr Surg 2009; 124:264e-266e. [PMID: 20009809 DOI: 10.1097/prs.0b013e3181b98e69] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Yoo JH, Kim EH, Min KD, Lee BI. Arthroscopic excision of the ganglion in the posterior septum by posterior trans-septal portal: report of two cases. Arch Orthop Trauma Surg 2009; 129:1047-51. [PMID: 18654790 DOI: 10.1007/s00402-008-0703-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2008] [Indexed: 12/23/2022]
Abstract
We report two cases of ganglion cysts in the posterior septum of the knee joint, one as parameniscal cyst from the posterior horn of the lateral meniscus extending to posterior septum, and the other as a cyst located in the posterior septum adjacent to the posterior cruciate ligament, which were both arthroscopically excised expediently by posterior trans-septal portal. The posterior compartment of the knee is not readily accessible by ordinary arthroscopic portals, and therefore has been considered as 'blind spot' conventionally. The posterior trans-septal portal is useful for assorted diagnostic or manipulative procedures in the posterior compartment of the knee.
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Vilchez F, Erquicia J, Pelfort X, Monllau JC. [Symptomatic ganglions in the knee joint. Report of three cases and literature review]. ACTA ORTOPEDICA MEXICANA 2009; 23:223-227. [PMID: 19960661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND The cystic lesions seen around the knee are usually meniscal or popliteal cysts. Cysts inside the articular cavity of the knee are rare and they are usually detected as incidental MRI findings. The ganglions originating in the cruciate ligaments or the infrapatellar fat have rarely been reported. We are reporting the cases of three intraarticular ganglions. The clinical diagnosis was made with magnetic resonance imaging. All patients were treated With arthroscopic surgery using the synovial shaver to remove the tissue. The three patients were reported as asymptomatic during the follow-up, with full range of motion. CONCLUSIONS The literature review shows that the origin of ganglions is controversial. The three reported cases show that this is a pathology that should be suspected, as it is difficult to diagnose. MRI is essential to make the diagnosis and the arthroscopic treatment of intraarticular ganglions is effective.
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Lima SM, de Souza Maliska MC, Dimitroulis G, Modolo F, Nazareno Gil J. Painful deviation of the mandible. ACTA ACUST UNITED AC 2009; 107:749-53. [PMID: 19230727 DOI: 10.1016/j.tripleo.2009.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2008] [Revised: 12/25/2008] [Accepted: 01/03/2009] [Indexed: 11/17/2022]
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Spinner RJ, Wang H, Hébert-Blouin MN, Skinner JA, Amrami KK. Sciatic cross-over in patients with peroneal and tibial intraneural ganglia confirmed by knee MR arthrography. Acta Neurochir (Wien) 2009; 151:89-98. [PMID: 19148568 DOI: 10.1007/s00701-008-0182-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2008] [Accepted: 11/20/2008] [Indexed: 12/14/2022]
Abstract
BACKGROUND A predictable mechanism and stereotypic patterns of peroneal intraneural ganglia are being defined based on careful analysis of MRIs. Peroneal and tibial intraneural ganglia extending from the superior tibiofibular joint which extend to the level of the sciatic nerve have been observed leading to the hypothesis that sciatic cross-over could exist. Such a cross-over phenomenon would allow intraneural cyst from the peroneal nerve by means of its shared epineurial sheath within the sciatic nerve to cross over to involve the tibial nerve, or vice versa from a tibial intraneural cyst to the peroneal nerve. METHOD AND FINDINGS One patient with a peroneal intraneural ganglion and another with a tibial intraneural ganglion each underwent a knee MR arthrogram. These studies were not only definitive in demonstrating the communication of the cyst to the superior tibiofibular joint connection but also in confirming sciatic cross-over. Contrast injected into the knee could be demonstrated tracking to the superior tibiofibular joint and then proximally into the common peroneal or tibial nerve respectively, crossing over at the sciatic nerve, and then descending down the tibial and peroneal nerves. The arthrographic findings mirrored MR images upon their retrospective review. CONCLUSIONS This study provides direct in vivo proof of the nature of sciatic cross-over theorized by critical review of MRIs and/or experimental dye injections done in cadavers. This study is important in clarifying the potential paths of propagation of intraneural cysts at points of major bifurcation.
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Inaparthy PK, Anwar F, Botchu R, Jähnich H, Katchburian MV. Compression of the deep branch of the ulnar nerve in Guyon's canal by a ganglion: two cases. Arch Orthop Trauma Surg 2008; 128:641-3. [PMID: 18509691 DOI: 10.1007/s00402-008-0636-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2006] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Ulnar nerve compression at the wrist can be caused by a variety of intrinsic and extrinsic factors. Isolated compression of only the deep branch of ulnar nerve by a ganglion is very uncommon. Ultrasound examination can clearly show the cystic lesion compressing the nerves. MATERIALS AND METHODS We present two cases of compression of deep branch of ulnar nerve by a ganglion in the Guyon's canal. Two male patients presented with history of progressive weakness and paraesthesia in the medial 1(1/2) digits of the non-dominant hand. Interestingly, both the patients noticed sudden onset and rapid progress of the symptoms and signs. Clinical examination revealed typical symptoms of ulnar nerve (deep branch) palsy. Nerve conduction studies showed severe denervation of the deep branch of the ulnar nerves in both the patients and ultrasound confirmed the diagnosis. Surgical decompression led to complete recovery. RESULTS AND DISCUSSION Whilst compression by a ganglion in the Guyon's canal is rare but well recognized, a feature of both of our cases was the rapid progression and severe nature of the compressive symptoms and signs. This is in contrast to the more typical features of compressive neuropathy and should alert the clinician to the possible underlying cause of compression. Early decompression has the potential to promote a complete recovery.
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Cebesoy O. Intraosseous ganglion of the talus treated with the talonavicular joint approach without exposing the ankle joint. J Am Podiatr Med Assoc 2008; 97:424-7. [PMID: 17901351 DOI: 10.7547/0970424] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Intraosseous ganglion, which is generally seen in metaphyseal-epiphyseal regions of long bones, is not a rare disorder. It is extremely rare in the talus, however. Differential diagnosis of a cystic talar lesion should include enchondroma, chondroblastoma, giant cell tumor, and unicameral bone cyst. This article presents a case of intraosseous ganglion of the talus in a 38-year-old woman treated with a new surgical approach and technique. The patient had mild ankle pain at the arc of motion in her right ankle that increased with activity. Radiographs and magnetic resonance images showed a cystic lesion in the medial side of the talar dome. It was treated by curettage and autocorticocancellous bone grafting through an opening in the talonavicular joint without disturbing the intact talar dome cartilage. One month after the operation, the patient had an excellent clinical outcome. This approach and technique can be used to treat other lesions of the talus that do not involve the joint space.
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Amin M, Torreggiani W, Sparkes J. Infrapatellar ganglion that developed from infrapatellar fat and had minimal intraarticular extension. Knee Surg Sports Traumatol Arthrosc 2008; 16:179-81. [PMID: 17899005 DOI: 10.1007/s00167-007-0406-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2007] [Accepted: 08/14/2007] [Indexed: 10/22/2022]
Abstract
Ganglia of the knee joint are rare and are mostly an incidental finding during arthroscopy or MRI examinations. Usually their origin is intraarticular, arising from the menisci or ACL or PCL. Ganglia arising from the infrapatellar fat pad are rare and only few are mentioned in the literature. We report a case of infrapattellar ganglion in a 41-year-old female, which developed from the infrapattellar fad pad and with minimal intraarticular extension.
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Titarenko IV. [Wrist ganglion]. VESTNIK KHIRURGII IMENI I. I. GREKOVA 2008; 167:87-88. [PMID: 18652225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Lee BCS, Yegappan M, Thiagarajan P. Suprascapular nerve neuropathy secondary to spinoglenoid notch ganglion cyst: case reports and review of literature. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2007; 36:1032-1035. [PMID: 18185886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
INTRODUCTION Suprascapular nerve neuropathy secondary to ganglion cyst impingement has increasingly been found to be a cause of shoulder pain. CLINICAL PICTURE We present 2 patients who complained of dull, poorly localised shoulder pain, which worsened with overhead activities. Magnetic resonance imaging showed ganglion cysts in the spinoglenoid notch. TREATMENT Both patients failed conservative management with physiotherapy and underwent shoulder arthroscopy. One patient underwent arthroscopic decompression of the cyst and the other had open excision of the cyst. OUTCOME Both patients experienced resolution of symptoms within 6 months of surgery. CONCLUSION With appropriate treatment, suprascapular nerve neuropathy secondary to ganglion cyst impingement is a treatable condition with potentially good results.
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Kanoun ML, Chebil M, Ayadi H, Ghamgui A, Hadded N, Ben Maitig M, Khorbi A, ben Hamouda M, Hachem A. Intraligamentous ganglion cyst of the anterior cruciate ligament (about a case). LA TUNISIE MEDICALE 2007; 85:1065-1067. [PMID: 19170389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
UNLABELLED UNKNO WLOGEMENT: Ganglion cysts have been reported in all joints, with varying frequency in location. A few cases have been described concerning ganglia of the anterior cruciate ligament (ACL) particularly intraligamentous cysts. AIM The aim of the study is to report specific particularities of intraligamentous ganglion cyst of the ACL. CASE We report a new case of intraligamentous ganglion cyst of the anterior cruciate ligament treated successfully with arthroscopic aspiration followed by partial excision of the cyst wall after MRI examination. The MR findings, clinical features and arthroscopic findings were evaluated comparatively. Diagnosis was confirmed by means of histological study after arthroscopic excision. The cyst was fluid-filled, with low T1-weighted signal intensity and high T2-weighted signal intensity. Pain was the most frequent clinical sign without any history of trauma. Postarthroscopy outcome was painless. Histologic diagnosis corresponded to ganglion cyst. CONCLUSION An intraligamentous ganglion cyst of the ACL is extremely rare and suggests some diagnostic and therapeutic particularities.
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Oztürk K, Esenyel CZ, Demir BB, Sönmez MM, Kara AN. [Occult scapholunate ganglion in patients with dorsoradial wrist pain]. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2007; 41:349-354. [PMID: 18180569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVES The aim of this study was to assess the results of surgical treatment of patients who had complaints of chronic wrist pain and were diagnosed as having an occult dorsal scapholunate interosseous ganglion, despite the presence of a normal x-ray and absence of trauma. METHODS Thirteen wrists of 12 patients (2 males, 10 females; mean age 28 years; range 21 to 41 years) were treated with surgical excision for ganglia originating from the dorsal scapholunate interosseous ligament. Involvement was on the right side in six patients, and on the left in five patients, with one patient having bilateral involvement. None of the patients had a history of trauma, except two with a history of fall. All the patients had complaints of wrist pain that occurred during work and subsided at rest. The mean duration of wrist pain was 23 months (range 6 to 60 months). All the patients received conservative treatment previously with wrist splints and non-steroidal anti-inflammatory drugs. Finger extension test was positive and magnetic resonance imaging of the wrist showed ganglion in all the patients. Functional results were evaluated by the Mayo Clinic wrist pain assessment scores after a mean follow-up of 35 months (range 25 to 49 months). RESULTS Complaints of wrist pain improved dramatically in all the patients. Scores of the Mayo Clinic wrist pain assessment were excellent in seven patients (53.9%), good in five patients (38.5%), and moderate in one patient (7.7%). All the patients returned to work without any limitation of wrist movements. No recurrences were seen during the follow-up period. CONCLUSION Occult ganglia originating from the scapholunate ligament should be remembered in patients with dorsal scapholunate joint tenderness and pain unresponsive to conservative treatment and with a positive finger extension test.
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Gazzeri R, Canova A, Fiore C, Galarza M, Neroni M, Giordano M. Acute Hemorrhagic Cyst of the Ligamentum Flavum. ACTA ACUST UNITED AC 2007; 20:536-8. [PMID: 17912132 DOI: 10.1097/bsd.0b013e31804b4605] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
STUDY DESIGN A case report and clinical discussion. OBJECTIVE To describe a rare complication of a cyst of the ligamentum flavum, which bled spontaneously, provoking an acute lower limb monoparesis and lumbar sciatic pain. SUMMARY OF BACKGROUNDS DATA: Cysts of the ligamentum flavum have been rarely reported. Intraspinal degenerative cysts described in literature are usually juxta-articular (synovial and ganglion) cysts and have a similar radiologic appearance. They are preferentially located in the lumbar spine, while the cervical localization is unusual. Hemorrhage into the cyst is an uncommon complication and an extremely rare cause of nerve root compression. METHODS A 59-year-old woman presented with sudden severe radicular lumbar deficit and pain secondary to acute hemorrhage into a ligamentum flavum cyst. Magnetic resonance imaging showed at L3-L4 level a lobulated slightly hyperintense mass with a ventral area of marked hyperintensity in T1 images, hypointense on T2 images. Signal within the lesion was suggestive of intralesional hemorrhage. RESULTS Complete resection of the lesion was performed, resulting in immediate recovery. The cyst was quite rounded, brownish, and contained rest of both partially fresh and coagulated hematoma. Histologic examination revealed myxoid degeneration of the ligamentum flavum with an hemorrage in the cystic cavity without a synovial layer. CONCLUSIONS This report identifies a rare case of radicular lumbar deficit and pain secondary to acute hemorrhage into a ligamentum flavum cyst. The pathogenesis and clinicopathologic characteristics of this lesion are described.
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Fogelson MH, Craig WD, McPhee JR, Lenert JT, Henry LR. Glenohumeral joint ganglion cyst and other rare cysts of the axilla. Am Surg 2007; 73:909-911. [PMID: 17939425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Although ganglion cysts have been reported to arise from almost any joint, those arising from the glenohumeral joint producing an axillary mass are extremely rare. We report what we believe to be the eighth such case and describe its management. The unusual differential diagnosis and aids to diagnosis of axillary cysts are reviewed. Specific issues regarding axillary space ganglions are emphasized.
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Wong NL, DI F. [Fine needle aspiration cytology of myxoid lesions of soft tissues: a study of 24 cases]. ZHONGHUA BING LI XUE ZA ZHI = CHINESE JOURNAL OF PATHOLOGY 2007; 36:619-623. [PMID: 18070452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To summarize the diagnostic features of fine needle aspiration cytology (FNAC) of myxoid lesions in soft tissue, and to define the cytological criteria for differentiating benign lesions from sarcomas and between various myxoid lesions. METHODS FNAC data of 24 soft tissue myxoid lesions (14 benign lesions, 10 malignant lesions) from 1993 to 2006 from Kiang Wu Hospital, Macau were reviewed in correlation with the clinical course or the results of biopsy. RESULTS Ganglion, myxoma, and myxoid nodular fasciitis were the most common benign myxoid lesions of the soft tissues, all of which had low cellularity and lack of marked cellular atypia in smears in common. Ganglion was characterized by the disappearance of or the gradual minimization of the nodule after aspiration and the lack of blood vessel in smears. Myxoid nodular fasciitis was characterized by a pleomorphic pattern of proliferative cells and the presence of ganglion cell-like cells. Myxoid liposarcoma, extraskeletal myxoid chondrosarcoma and myxofibrosarcoma were the most common myxoid sarcomas. Cytologically, they had high cellularity and various degrees of cellular atypia. Myxoid liposarcoma exhibited branching chicken-wire like capillary vessels and/or lipoblasts; myxofibrosarcoma were prominent in both pleomorphic and atypia of the cells. The data revealed that the diagnostic accuracy of FNAC was nearly 100% in differentiating benign and malignant myxoid lesions of the soft tissues. The coordinate rate to the histopathology diagnosis of the common myxoid lesions of the soft tissues was above 75% (benign 71.4% and malignancy 80% respectively). CONCLUSIONS FNAC is an effective method in diagnosing myxoid lesions of soft tissue, in correlation with the clinical data and the accessory examinations. FNAC can provide an objective basis for the treatment of myxoid lesions and prevention of unnecessary surgical operations.
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Spinner RJ, Desy NM, Rock MG, Amrami KK. Peroneal intraneural ganglia. Part I. Techniques for successful diagnosis and treatment. Neurosurg Focus 2007; 22:E16. [PMID: 17613207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The common peroneal nerve is the peripheral nerve most often affected by intraneural ganglion cysts. Although the pathogenesis of these cysts has been the subject of controversy in the literature, it is becoming increasingly evident that they are of articular origin. Recent recognition of this fact has proven to be significant in reducing recurrences and improving treatment outcomes for patients. The authors present a stepwise method of assessing and treating peroneal intraneural ganglion cysts.
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Spinner RJ, Desy NM, Rock MG, Amrami KK. Peroneal intraneural ganglia. Part II. Lessons learned and pitfalls to avoid for successful diagnosis and treatment. Neurosurg Focus 2007; 22:E27. [PMID: 17613219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The authors describe common modes of failure in the diagnosis and treatment of patients with peroneal intraneural ganglia. Illustrated examples correlate the modes of failure and the diagnostic or surgical errors. Understanding these pitfalls reinforces the rationale behind current treatment recommendations as outlined in the companion article. Avoiding these pitfalls will ultimately improve outcomes.
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Osuji OU, McAdams TR. Dorsoulnar wrist ganglion associated with os ulnostyloideum: a case report. AMERICAN JOURNAL OF ORTHOPEDICS (BELLE MEAD, N.J.) 2007; 36:E94-6. [PMID: 17643151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
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Abstract
Mucous cysts are common problems seen by hand surgeons. Surgical excision of symptomatic cysts is the most commonly accepted treatment. Removal of large mucous cysts often requires simultaneous flap coverage or skin grafting for the resulting defect. We present the use of a dorsal advancement flap to permit excellent skin coverage after cyst excision with a tension-free closure.
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121
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Thaunat M, Chambat P. Pretibial ganglion-like cyst formation after anterior cruciate ligament reconstruction: a consequence of the incomplete bony integration of the graft? Knee Surg Sports Traumatol Arthrosc 2007; 15:522-4. [PMID: 17103004 DOI: 10.1007/s00167-006-0218-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2006] [Accepted: 09/18/2006] [Indexed: 12/01/2022]
Abstract
We report a case of subcutaneous pretibial ganglion, with direct communication to the tibial tunnel after an autologous reconstruction of the anterior cruciate ligament with hamstring tendons. The tibial graft fixation was with a 9 mm poly-L-lactide interference screw 5 years earlier. The screw had undergone complete resorption at the time the cyst occurred. No joint inflammatory reaction or graft insufficiency was detected. The patient underwent cyst excision and curettage of the tibial tunnel with full recovery. This complication seems to be the consequence of a direct communication between the joint and the pretibial subcutaneous tissue through a fibrous tibial tunnel and would have occurred, as there is no full osteointegration of the graft due to the resorption of the bioabsorbable interference screw.
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Kessler MA, Stoffel K, Oswald A, Stutz G, Gaechter A. The SLAP lesion as a reason for glenolabral cysts: a report of five cases and review of the literature. Arch Orthop Trauma Surg 2007; 127:287-92. [PMID: 16738925 DOI: 10.1007/s00402-006-0154-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2004] [Indexed: 02/09/2023]
Abstract
INTRODUCTION Cysts in the spinoglenoidal or supraglenoidal incisura can be a cause of compression of the suprascapular nerve. There is agglomerated appearance of these cysts in combination with SLAP lesions. Hypothesis is SLAP lesions can lead to cysts in this region and should be repaired. MATERIAL AND METHODS MRI of five patients (all male, four 30-40 years, one 75 years) showed cysts in the supralabral region. All were in combination with lesions of the superior glenoidal labrum (Type II or more). RESULTS In two cases, in addition to cyst resection, the SLAP lesion was also repaired and symptoms disappeared completely and no recurrent cyst was detected in postoperative MRI. Two patients without SLAP repair showed recurrent cystic formation in MRI with similar complaints compared to their preoperative status. One patient (75 years) was treated primarily by puncture and afterwards with open resection of the cyst. His outcome was good in terms of activities of daily living without major pain. CONCLUSIONS Our results are based on the assumption that cysts in the region of the spinoglenoidal/supraglenoidal incisura can originate from SLAP lesions. If a patient is suspected of having cysts in this region, the question of a SLAP lesion should be clarified. SLAP lesions should be repaired to avoid relapse. Arthroscopic repair of SLAP lesion can lead to the disappearance of symptoms in younger patients. In older patients puncture or resection of the ganglion alone may be an adequate therapeutic strategy.
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Huang JI, Gilmore A. Ganglion cysts of the midfoot presenting as bilateral accessory tarsal navicular bones in a child: a case report. Foot Ankle Int 2007; 28:621-3. [PMID: 17559772 DOI: 10.3113/fai.2007.0621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Nielsen NHS, Jensen NV. [Ganglion--cysts of the hand and wrist]. Ugeskr Laeger 2007; 169:1303-5. [PMID: 17437691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Ganglion cysts of the hand and wrist occur most frequently during the second through fourth decade and women are more frequently affected than men. Ganglion cysts may arise in any location in the hand and wrist but are usually adjacent to joins or tendons and sometimes bones. Patients often present with a history of an asymptomatic mass and many patients seek the advice of a physician because of the cosmetic appearance of the cyst. Observation is acceptable in most instances. Indication for operative treatment includes pain, interference with activity, nerve compression and ulceration of the mucous cysts.
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Spinner RJ, Mokhtarzadeh A, Schiefer TK, Krishnan KG, Kliot M, Amrami KK. The clinico-anatomic explanation for tibial intraneural ganglion cysts arising from the superior tibiofibular joint. Skeletal Radiol 2007; 36:281-92. [PMID: 17187290 DOI: 10.1007/s00256-006-0213-2] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2006] [Revised: 08/23/2006] [Accepted: 08/24/2006] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To demonstrate that tibial intraneural ganglia in the popliteal fossa are derived from the posterior portion of the superior tibiofibular joint, in a mechanism similar to that of peroneal intraneural ganglia, which have recently been shown to arise from the anterior portion of the same joint. DESIGN Retrospective clinical study and prospective anatomic study. MATERIALS The clinical records and MRI findings of three patients with tibial intraneural ganglion cysts were analyzed and compared with those of one patient with a tibial extraneural ganglion cyst and one volunteer. Seven cadaveric limbs were dissected to define the articular anatomy of the posterior aspect of the superior tibiofibular joint. RESULTS The condition of the three patients with intraneural ganglia recurred because their joint connections were not identified initially. In two patients there was no cyst recurrence when the joint connection was treated at revision surgery; the third patient did not wish to undergo additional surgery. The one patient with an extraneural ganglion had the joint connection identified at initial assessment and had successful surgery addressing the cyst and the joint connection. Retrospective evaluation of the tibial intraneural ganglion cysts revealed stereotypic features, which allowed their accurate diagnosis and distinction from extraneural cases. The intraneural cysts had tubular (rather than globular) appearances. They derived from the postero-inferior portion of the superior tibiofibular joint and followed the expected course of the articular branch on the posterior surface of the popliteus muscle. The cysts then extended intra-epineurially into the parent tibial nerves, where they contained displaced nerve fascicles. The extraneural cyst extrinsically compressed the tibial nerve but did not directly involve it. All cadaveric specimens demonstrated a small single articular branch, which derived from the tibial nerve to the popliteus. The branch coursed obliquely across the posterior surface of the popliteus muscle before innervating the postero-inferior aspect of the superior tibiofibular joint. CONCLUSIONS The clinical, MRI and anatomic features of tibial intraneural ganglion cysts are the posterior counterpart of the peroneal intraneural ganglion cysts arising from the anterior portion of the superior tibiofibular joint. These predictable features can be exploited and have implications for the pathogenesis of these intraneural cysts and treatment outcomes. These ganglion cysts are joint-related and provide further evidence to support the unifying articular theory. In each case the joint connection needs to be identified preoperatively, and the articular branches and the superior tibiofibular joint should be addressed operatively to prevent cyst recurrence.
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