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Erschienen in: Skeletal Radiology 10/2006

01.10.2006 | Scientific Article

Coexisting secondary intraneural and vascular adventitial ganglion cysts of joint origin: a causal rather than a coincidental relationship supporting an articular theory

verfasst von: Robert J. Spinner, Bernd W. Scheithauer, Nicholas M. Desy, Michael G. Rock, Frederik C. Holdt, Kimberly K. Amrami

Erschienen in: Skeletal Radiology | Ausgabe 10/2006

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Abstract

Objective

To introduce the clinical entity of an intraneural ganglion cyst coexisting with a vascular adventitial cyst arising from the same joint.

Design

Retrospective review.

Patients

Two patients presented with predominantly deep peroneal neuropathy due to complex superior tibiofibular joint-related cysts. In addition to having peroneal intraneural ganglion cysts, these patients had vascular adventitial cysts: one involving a capsular arterial branch, the other a capsular vein [as well as a large, recurrent, intramuscular (extraneural) ganglion]. We then reviewed MRIs of 12 other consecutive cases of intraneural ganglia (10 peroneal and 2 tibial) arising from the superior tibiofibular joint that we treated, as well as other reported cases in the literature to determine if there were other (unrecognized) examples supporting the combination of clinical findings and radiographic patterns.

Results

Retrospective analysis of MRIs in the two surgically proven cases of peroneal intraneural ganglia with vascular adventitial cyst extension showed a common imaging pattern that we have termed “the wishbone sign,” consisting of the connection of the ascending limb of the peroneal intraneural ganglion and the longitudinal limb of the vascular adventitial cyst in the axial plane. Our review suggests that vascular adventitial cyst extension occurs in a large proportion of cases of peroneal intraneural ganglia. A similar growth pattern was noted in a case of a tibial intraneural ganglion.

Conclusions

The combination of intraneural and vascular adventitial cysts is understandable given our knowledge of normal and pathologic anatomy of para-articular cysts. The combination of intraneural ganglia and vascular adventitial cysts broadens the spectrum of clinical presentations of these cysts and suggests that cysts and their content can dissect from a joint along neurovascular bundles. These cases provide important evidence to support the articular theory for the pathogenesis of not only neural but vascular adventitial cysts as well.
Literatur
1.
Zurück zum Zitat Malghem J, Vande berg BC, Lebon C, Lecouvet FE, Maldague BE. Ganglion cysts of the knee: articular communication revealed by delayed radiography and CT after arthrography. AJR Am J Roentgenol 1998;170:1579–1583CrossRef Malghem J, Vande berg BC, Lebon C, Lecouvet FE, Maldague BE. Ganglion cysts of the knee: articular communication revealed by delayed radiography and CT after arthrography. AJR Am J Roentgenol 1998;170:1579–1583CrossRef
2.
Zurück zum Zitat Malghem J, Vande BB, Lecouvet F, Lebon C, Maldague B. [Atypical ganglion cysts]. Jbr-Btr 2002;85:34–42PubMed Malghem J, Vande BB, Lecouvet F, Lebon C, Maldague B. [Atypical ganglion cysts]. Jbr-Btr 2002;85:34–42PubMed
3.
Zurück zum Zitat Rezzouk J, Durandeau A. [Nerve compression by mucoid pseudocysts: arguments favoring an articular cause in 23 patients]. Rev Chir Orthop Reparatrice Appar Mot 2004;90:143–146CrossRef Rezzouk J, Durandeau A. [Nerve compression by mucoid pseudocysts: arguments favoring an articular cause in 23 patients]. Rev Chir Orthop Reparatrice Appar Mot 2004;90:143–146CrossRef
4.
Zurück zum Zitat Spinner RJ, Atkinson JL, Scheithauer BW, et al. Peroneal intraneural ganglia: the importance of the articular branch. Clinical series. J Neurosurg 2003;99:319–329CrossRef Spinner RJ, Atkinson JL, Scheithauer BW, et al. Peroneal intraneural ganglia: the importance of the articular branch. Clinical series. J Neurosurg 2003;99:319–329CrossRef
5.
Zurück zum Zitat Spinner RJ, Atkinson JL, Tiel RL. Peroneal intraneural ganglia: the importance of the articular branch. A unifying theory. J Neurosurg 2003;99:330–343CrossRef Spinner RJ, Atkinson JL, Tiel RL. Peroneal intraneural ganglia: the importance of the articular branch. A unifying theory. J Neurosurg 2003;99:330–343CrossRef
6.
Zurück zum Zitat Spinner RJ, Edwards PK, Amrami KK. Application of three-dimensional rendering in joint-related ganglion cysts. Clin Anat 2006; 19:312–322CrossRef Spinner RJ, Edwards PK, Amrami KK. Application of three-dimensional rendering in joint-related ganglion cysts. Clin Anat 2006; 19:312–322CrossRef
7.
Zurück zum Zitat Spinner RJ, Desy NM, Amrami KK. Cystic transverse limb of the articular branch: a pathognomonic sign for peroneal intraneural ganglia at the superior tibiofibular joint. Neurosurgery 2006; 59:157–166CrossRef Spinner RJ, Desy NM, Amrami KK. Cystic transverse limb of the articular branch: a pathognomonic sign for peroneal intraneural ganglia at the superior tibiofibular joint. Neurosurgery 2006; 59:157–166CrossRef
8.
Zurück zum Zitat Damron TA, Rock MG. Unusual manifestations of proximal tibiofibular joint synovial cysts. Orthopedics 1997;20:225–230PubMed Damron TA, Rock MG. Unusual manifestations of proximal tibiofibular joint synovial cysts. Orthopedics 1997;20:225–230PubMed
9.
Zurück zum Zitat Spinner R. Lettre à la rédaction. Rev Chirurg Orthop Reparatrice L’Appareil Moteur 2005;91:492–494 Spinner R. Lettre à la rédaction. Rev Chirurg Orthop Reparatrice L’Appareil Moteur 2005;91:492–494
10.
Zurück zum Zitat Spinner RJ, Atkinson JL, Harper CM Jr, Wenger DE. Recurrent intraneural ganglion cyst of the tibial nerve. Case report. J Neurosurg 2000;92:334–337CrossRef Spinner RJ, Atkinson JL, Harper CM Jr, Wenger DE. Recurrent intraneural ganglion cyst of the tibial nerve. Case report. J Neurosurg 2000;92:334–337CrossRef
11.
Zurück zum Zitat Spinner RJ, Dellon AL, Rosson GD, Amrami KK. Tibial intraneural ganglia in the tarsal tunnel: is there a joint connection? Clin Anat 2005;18:640–641 (abstract) Spinner RJ, Dellon AL, Rosson GD, Amrami KK. Tibial intraneural ganglia in the tarsal tunnel: is there a joint connection? Clin Anat 2005;18:640–641 (abstract)
12.
Zurück zum Zitat Hori S, Sugimura I, Muraoka H, Tatsukawa K, Kuroki H. Intraneural ganglion of the ulnar nerve. Report of two cases. Jpn Orthop Surg Traum Surg 1986;35:269–273 Hori S, Sugimura I, Muraoka H, Tatsukawa K, Kuroki H. Intraneural ganglion of the ulnar nerve. Report of two cases. Jpn Orthop Surg Traum Surg 1986;35:269–273
13.
Zurück zum Zitat Zielinski CJ. Intraneural ganglion of the ulnar nerve at the wrist. Orthopedics 2003;26:429–430PubMed Zielinski CJ. Intraneural ganglion of the ulnar nerve at the wrist. Orthopedics 2003;26:429–430PubMed
14.
Zurück zum Zitat Jaradeh S, Sanger JR, Maas EF. Isolated sensory impairment of the thumb due to an intraneural ganglion cyst in the median nerve. J Hand Surg [Br] 1995;20:475–478CrossRef Jaradeh S, Sanger JR, Maas EF. Isolated sensory impairment of the thumb due to an intraneural ganglion cyst in the median nerve. J Hand Surg [Br] 1995;20:475–478CrossRef
15.
Zurück zum Zitat Spinner RJ, Amrami KK, Kliot M, Johnston SP, Casaňas J. Suprascapular intraneural ganglia and glenohumeral joint connections. J Neurosurg 2006;104:551–557CrossRef Spinner RJ, Amrami KK, Kliot M, Johnston SP, Casaňas J. Suprascapular intraneural ganglia and glenohumeral joint connections. J Neurosurg 2006;104:551–557CrossRef
16.
Zurück zum Zitat Vanhoenacker FM, Vandevenne JE, De Schepper AM, De Leersnijder J. Regarding “Adventitial cystic disease: a unifying hypothesis”. J Vasc Surg 2000;31:621–622CrossRef Vanhoenacker FM, Vandevenne JE, De Schepper AM, De Leersnijder J. Regarding “Adventitial cystic disease: a unifying hypothesis”. J Vasc Surg 2000;31:621–622CrossRef
Metadaten
Titel
Coexisting secondary intraneural and vascular adventitial ganglion cysts of joint origin: a causal rather than a coincidental relationship supporting an articular theory
verfasst von
Robert J. Spinner
Bernd W. Scheithauer
Nicholas M. Desy
Michael G. Rock
Frederik C. Holdt
Kimberly K. Amrami
Publikationsdatum
01.10.2006
Verlag
Springer Berlin Heidelberg
Erschienen in
Skeletal Radiology / Ausgabe 10/2006
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-006-0148-7

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