Skip to main content
Erschienen in:

10.01.2022 | Scientific Article

Juxtaneural ganglia arising from the hip joint: focus on magnetic resonance imaging findings and clinical manifestations

verfasst von: Nari Shin, Hyun Su Kim, Ji Hyun Lee, So Yeon Cha, Min Jae Cha

Erschienen in: Skeletal Radiology | Ausgabe 7/2022

Einloggen, um Zugang zu erhalten

Abstract

Objective

To present cases of juxtaneural ganglia arising from the hip with a discussion of the magnetic resonance imaging (MRI) findings, presenting symptoms, and possible treatment option.

Materials and methods

Two radiologists performed a consensus review of MRI scans obtained between January 2013 and March 2021 to identify patients with juxtaneural ganglia around the hip. A total of 11 patients with 11 juxtaneural ganglia were identified. Medical records and MRI findings were retrospectively reviewed.

Results

Eight patients had lesions involving the sciatic nerve, and three patients had lesions involving the obturator nerve. Sciatic ganglia arose from a paralabral cyst in the posteroinferior quadrant and continued through a narrow channel running along the posterior acetabulum, showing increased diameter in the sciatic foramen and intrapelvic portion. Obturator ganglia showed a J- or reverse J-shape on the coronal imaging plane and extended from a paralabral cyst in the anteroinferior quadrant via the obturator canal. Nine patients (9/11, 81.8%) had symptoms resembling those of lumbosacral radiculopathy. Four patients underwent arthroscopic surgery, and one patient underwent ultrasound-guided aspiration, all of whom showed partial improvement. Spontaneous decrease in the extent of the ganglion was observed in three patients (3/11, 27.3%).

Conclusion

This article describes rare cases of juxtaneural ganglia arising from the hip joint and involving the sciatic and obturator nerves. The lesions share similar MRI findings, and each type of cyst (sciatic or obturator ganglia) involves a specific labral quadrant.
Literatur
1.
Zurück zum Zitat Desy NM, Wang H, Elshiekh MA, et al. Intraneural ganglion cysts: a systematic review and reinterpretation of the world’s literature. J Neurosurg. 2016;125(3):615–30.CrossRef Desy NM, Wang H, Elshiekh MA, et al. Intraneural ganglion cysts: a systematic review and reinterpretation of the world’s literature. J Neurosurg. 2016;125(3):615–30.CrossRef
2.
Zurück zum Zitat Spinner RJ, Hebert-Blouin MN, Trousdale RT, et al. Intraneural ganglia in the hip and pelvic region. Clinical article J Neurosurg. 2009;111(2):317–25.CrossRef Spinner RJ, Hebert-Blouin MN, Trousdale RT, et al. Intraneural ganglia in the hip and pelvic region. Clinical article J Neurosurg. 2009;111(2):317–25.CrossRef
3.
Zurück zum Zitat Desy NM, Lipinski LJ, Tanaka S, Amrami KK, Rock MG, Spinner RJ. Recurrent intraneural ganglion cysts: pathoanatomic patterns and treatment implications. Clin Anat. 2015;28(8):1058–69.CrossRef Desy NM, Lipinski LJ, Tanaka S, Amrami KK, Rock MG, Spinner RJ. Recurrent intraneural ganglion cysts: pathoanatomic patterns and treatment implications. Clin Anat. 2015;28(8):1058–69.CrossRef
4.
Zurück zum Zitat Spinner RJ, Vincent JF, Wolanskyj AP, Scheithauer BW. Intraneural ganglion cyst: a 200-year-old mystery solved. Clin Anat. 2008;21(7):611–8.CrossRef Spinner RJ, Vincent JF, Wolanskyj AP, Scheithauer BW. Intraneural ganglion cyst: a 200-year-old mystery solved. Clin Anat. 2008;21(7):611–8.CrossRef
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(2):330–43.CrossRef Spinner RJ, Atkinson JL, Tiel RL. Peroneal intraneural ganglia: the importance of the articular branch. A unifying theory J Neurosurg. 2003;99(2):330–43.CrossRef
6.
Zurück zum Zitat Spinner RJ, Amrami KK, Wolanskyj AP, et al. Dynamic phases of peroneal and tibial intraneural ganglia formation: a new dimension added to the unifying articular theory. J Neurosurg. 2007;107(2):296–307.CrossRef Spinner RJ, Amrami KK, Wolanskyj AP, et al. Dynamic phases of peroneal and tibial intraneural ganglia formation: a new dimension added to the unifying articular theory. J Neurosurg. 2007;107(2):296–307.CrossRef
7.
Zurück zum Zitat Spinner RJ, Luthra G, Desy NM, Anderson ML, Amrami KK. The clock face guide to peroneal intraneural ganglia: critical “times” and sites for accurate diagnosis. Skeletal Radiol. 2008;37(12):1091–9.CrossRef Spinner RJ, Luthra G, Desy NM, Anderson ML, Amrami KK. The clock face guide to peroneal intraneural ganglia: critical “times” and sites for accurate diagnosis. Skeletal Radiol. 2008;37(12):1091–9.CrossRef
8.
Zurück zum Zitat Spinner RJ, Desy NM, Amrami KK, Vosoughi AR, Klaue K. Expanding on the term “balloon” sign. Acta Neurochir (Wien). 2016;158(10):1891–3.CrossRef Spinner RJ, Desy NM, Amrami KK, Vosoughi AR, Klaue K. Expanding on the term “balloon” sign. Acta Neurochir (Wien). 2016;158(10):1891–3.CrossRef
9.
Zurück zum Zitat Nagpal AS, Brennick C, Occhialini AP, et al. Innervation of the posterior hip capsule: a cadaveric study. Pain Med. 2021;22(5):1072–9.CrossRef Nagpal AS, Brennick C, Occhialini AP, et al. Innervation of the posterior hip capsule: a cadaveric study. Pain Med. 2021;22(5):1072–9.CrossRef
10.
Zurück zum Zitat Jitpun E, Howe BMM, Amrami KK, Trousdale RT, Spinner RJ. Obturator intraneural ganglion cysts: joint connected and underdiagnosed. World Neurosurg. 2019;126:e259–69.CrossRef Jitpun E, Howe BMM, Amrami KK, Trousdale RT, Spinner RJ. Obturator intraneural ganglion cysts: joint connected and underdiagnosed. World Neurosurg. 2019;126:e259–69.CrossRef
11.
Zurück zum Zitat Beaman FD, Kransdorf MJ, Menke DM. Schwannoma: radiologic-pathologic correlation. Radiographics. 2004;24(5):1477–81.CrossRef Beaman FD, Kransdorf MJ, Menke DM. Schwannoma: radiologic-pathologic correlation. Radiographics. 2004;24(5):1477–81.CrossRef
12.
Zurück zum Zitat Palmer W, Bancroft L, Bonar F, et al. Glossary of terms for musculoskeletal radiology. Skeletal Radiol. 2020;49(Suppl 1):1–33.CrossRef Palmer W, Bancroft L, Bonar F, et al. Glossary of terms for musculoskeletal radiology. Skeletal Radiol. 2020;49(Suppl 1):1–33.CrossRef
13.
Zurück zum Zitat Torriani M, Souto SC, Thomas BJ, Ouellette H, Bredella MA. Ischiofemoral impingement syndrome: an entity with hip pain and abnormalities of the quadratus femoris muscle. AJR Am J Roentgenol. 2009;193(1):186–90.CrossRef Torriani M, Souto SC, Thomas BJ, Ouellette H, Bredella MA. Ischiofemoral impingement syndrome: an entity with hip pain and abnormalities of the quadratus femoris muscle. AJR Am J Roentgenol. 2009;193(1):186–90.CrossRef
14.
Zurück zum Zitat Tosun O, Algin O, Yalcin N, Cay N, Ocakoglu G, Karaoglanoglu M. Ischiofemoral impingement: evaluation with new MRI parameters and assessment of their reliability. Skeletal Radiol. 2012;41(5):575–87.CrossRef Tosun O, Algin O, Yalcin N, Cay N, Ocakoglu G, Karaoglanoglu M. Ischiofemoral impingement: evaluation with new MRI parameters and assessment of their reliability. Skeletal Radiol. 2012;41(5):575–87.CrossRef
15.
Zurück zum Zitat Mascarenhas VV, Castro MO, Rego PA, et al. The Lisbon Agreement on Femoroacetabular Impingement Imaging-part 1: overview. Eur Radiol. 2020;30(10):5281–97.CrossRef Mascarenhas VV, Castro MO, Rego PA, et al. The Lisbon Agreement on Femoroacetabular Impingement Imaging-part 1: overview. Eur Radiol. 2020;30(10):5281–97.CrossRef
16.
Zurück zum Zitat Spinner RJ, Scheithauer BW, Desy NM, Rock MG, Holdt FC, Amrami KK. Coexisting secondary intraneural and vascular adventitial ganglion cysts of joint origin: a causal rather than a coincidental relationship supporting an articular theory. Skeletal Radiol. 2006;35(10):734–44.CrossRef Spinner RJ, Scheithauer BW, Desy NM, Rock MG, Holdt FC, Amrami KK. Coexisting secondary intraneural and vascular adventitial ganglion cysts of joint origin: a causal rather than a coincidental relationship supporting an articular theory. Skeletal Radiol. 2006;35(10):734–44.CrossRef
17.
Zurück zum Zitat Birnbaum K, Prescher A, Hessler S, Heller KD. The sensory innervation of the hip joint—an anatomical study. Surg Radiol Anat. 1997;19(6):371–5.CrossRef Birnbaum K, Prescher A, Hessler S, Heller KD. The sensory innervation of the hip joint—an anatomical study. Surg Radiol Anat. 1997;19(6):371–5.CrossRef
18.
Zurück zum Zitat Kampa RJ, Prasthofer A, Lawrence-Watt DJ, Pattison RM. The internervous safe zone for incision of the capsule of the hip. A cadaver study. J Bone Joint Surg Br. 2007;89(7):971–6. Kampa RJ, Prasthofer A, Lawrence-Watt DJ, Pattison RM. The internervous safe zone for incision of the capsule of the hip. A cadaver study. J Bone Joint Surg Br. 2007;89(7):971–6.
19.
Zurück zum Zitat Peri G. The, “critical zones” of entrapment of the nerves of the lower limb. Surg Radiol Anat. 1991;13(2):139–43.CrossRef Peri G. The, “critical zones” of entrapment of the nerves of the lower limb. Surg Radiol Anat. 1991;13(2):139–43.CrossRef
20.
Zurück zum Zitat Yukata K, Arai K, Yoshizumi Y, Tamano K, Imada K, Nakaima N. Obturator neuropathy caused by an acetabular labral cyst: MRI findings. AJR Am J Roentgenol. 2005;184(3 Suppl):S112–4.CrossRef Yukata K, Arai K, Yoshizumi Y, Tamano K, Imada K, Nakaima N. Obturator neuropathy caused by an acetabular labral cyst: MRI findings. AJR Am J Roentgenol. 2005;184(3 Suppl):S112–4.CrossRef
21.
Zurück zum Zitat Vidoni A, Sankara STV, Ramana V, Botchu R. Ganglion cyst arising from the transverse acetabular ligament (TAL): a rare cause of entrapment of the anterior branch of the obturator nerve. Case report and review of the literature. Skeletal Radiol. 2019;48(1):163–5. Vidoni A, Sankara STV, Ramana V, Botchu R. Ganglion cyst arising from the transverse acetabular ligament (TAL): a rare cause of entrapment of the anterior branch of the obturator nerve. Case report and review of the literature. Skeletal Radiol. 2019;48(1):163–5.
22.
Zurück zum Zitat Lovaglio AC, Mansilla B, Cejas C, Spinner RJ, Socolovsky M. Femoral intraneural ganglion cyst: the first confirmed case report. Br J Neurosurg. 2020:1–3. Lovaglio AC, Mansilla B, Cejas C, Spinner RJ, Socolovsky M. Femoral intraneural ganglion cyst: the first confirmed case report. Br J Neurosurg. 2020:1–3.
23.
Zurück zum Zitat James SL, Ali K, Malara F, Young D, O’Donnell J, Connell DA. MRI findings of femoroacetabular impingement. AJR Am J Roentgenol. 2006;187(6):1412–9.CrossRef James SL, Ali K, Malara F, Young D, O’Donnell J, Connell DA. MRI findings of femoroacetabular impingement. AJR Am J Roentgenol. 2006;187(6):1412–9.CrossRef
24.
Zurück zum Zitat Magerkurth O, Jacobson JA, Girish G, Brigido MK, Bedi A, Fessell D. Paralabral cysts in the hip joint: findings at MR arthrography. Skeletal Radiol. 2012;41(10):1279–85.CrossRef Magerkurth O, Jacobson JA, Girish G, Brigido MK, Bedi A, Fessell D. Paralabral cysts in the hip joint: findings at MR arthrography. Skeletal Radiol. 2012;41(10):1279–85.CrossRef
25.
Zurück zum Zitat Chhabra A, Lee PP, Bizzell C, Soldatos T. 3 Tesla MR neurography—technique, interpretation, and pitfalls. Skeletal Radiol. 2011;40(10):1249–60.CrossRef Chhabra A, Lee PP, Bizzell C, Soldatos T. 3 Tesla MR neurography—technique, interpretation, and pitfalls. Skeletal Radiol. 2011;40(10):1249–60.CrossRef
26.
Zurück zum Zitat Chhabra A, Madhuranthakam AJ, Andreisek G. Magnetic resonance neurography: current perspectives and literature review. Eur Radiol. 2018;28(2):698–707.CrossRef Chhabra A, Madhuranthakam AJ, Andreisek G. Magnetic resonance neurography: current perspectives and literature review. Eur Radiol. 2018;28(2):698–707.CrossRef
27.
Zurück zum Zitat Knoll A, Pal’a A, Pedro MT, et al. Clinical outcome after decompression of intraneural peroneal ganglion cyst and its morphologic correlation to postoperative nerve ultrasound. J Neurosurg. 2019:1–7. Knoll A, Pal’a A, Pedro MT, et al. Clinical outcome after decompression of intraneural peroneal ganglion cyst and its morphologic correlation to postoperative nerve ultrasound. J Neurosurg. 2019:1–7.
28.
Zurück zum Zitat Park SH, Do HK, Jo GY. Compressive peroneal neuropathy by an intraneural ganglion cyst combined with L5 radiculopathy: a case report. Medicine (Baltimore). 2019;98(44):e17865. Park SH, Do HK, Jo GY. Compressive peroneal neuropathy by an intraneural ganglion cyst combined with L5 radiculopathy: a case report. Medicine (Baltimore). 2019;98(44):e17865.
29.
Zurück zum Zitat Liang T, Panu A, Crowther S, Low G, Lambert R. Ultrasound-guided aspiration and injection of an intraneural ganglion cyst of the common peroneal nerve. HSS J. 2013;9(3):270–4.CrossRef Liang T, Panu A, Crowther S, Low G, Lambert R. Ultrasound-guided aspiration and injection of an intraneural ganglion cyst of the common peroneal nerve. HSS J. 2013;9(3):270–4.CrossRef
30.
Zurück zum Zitat Li P, Lou D, Lu H. The cubital tunnel syndrome caused by intraneural ganglion cyst of the ulnar nerve at the elbow: a case report. BMC Neurol. 2018;18(1):217.CrossRef Li P, Lou D, Lu H. The cubital tunnel syndrome caused by intraneural ganglion cyst of the ulnar nerve at the elbow: a case report. BMC Neurol. 2018;18(1):217.CrossRef
31.
Zurück zum Zitat Kim SH, Seok H, Lee SY, Park SW. Acetabular paralabral cyst as a rare cause of obturator neuropathy: a case report. Ann Rehabil Med. 2014;38(3):427–32.CrossRef Kim SH, Seok H, Lee SY, Park SW. Acetabular paralabral cyst as a rare cause of obturator neuropathy: a case report. Ann Rehabil Med. 2014;38(3):427–32.CrossRef
32.
Zurück zum Zitat Elangovan S, Odegard GM, Morrow DA, Wang H, Hebert-Blouin MN, Spinner RJ. Intraneural ganglia: a clinical problem deserving a mechanistic explanation and model. Neurosurg Focus. 2009;26(2):E11.CrossRef Elangovan S, Odegard GM, Morrow DA, Wang H, Hebert-Blouin MN, Spinner RJ. Intraneural ganglia: a clinical problem deserving a mechanistic explanation and model. Neurosurg Focus. 2009;26(2):E11.CrossRef
Metadaten
Titel
Juxtaneural ganglia arising from the hip joint: focus on magnetic resonance imaging findings and clinical manifestations
verfasst von
Nari Shin
Hyun Su Kim
Ji Hyun Lee
So Yeon Cha
Min Jae Cha
Publikationsdatum
10.01.2022
Verlag
Springer Berlin Heidelberg
Erschienen in
Skeletal Radiology / Ausgabe 7/2022
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-022-03989-8

Neu im Fachgebiet Radiologie

KI-gestütztes Mammografiescreening überzeugt im Praxistest

Mit dem Einsatz künstlicher Intelligenz lässt sich die Detektionsrate im Mammografiescreening offenbar deutlich steigern. Mehr unnötige Zusatzuntersuchungen sind laut der Studie aus Deutschland nicht zu befürchten.

Stumme Schlaganfälle − ein häufiger Nebenbefund im Kopf-CT?

In 4% der in der Notfallambulanz initiierten zerebralen Bildgebung sind „alte“ Schlaganfälle zu erkennen. Gar nicht so selten handelt es sich laut einer aktuellen Studie dabei um unbemerkte Insulte. Bietet sich hier womöglich die Chance auf ein effektives opportunistisches Screening?

Die elektronische Patientenakte kommt: Das sollten Sie jetzt wissen

Am 15. Januar geht die „ePA für alle“ zunächst in den Modellregionen an den Start. Doch schon bald soll sie in allen Praxen zum Einsatz kommen. Was ist jetzt zu tun? Was müssen Sie wissen? Wir geben in einem FAQ Antworten auf 21 Fragen.

Stören weiße Wände und viel Licht die Bildqualitätskontrolle?

Wenn es darum geht, die technische Qualität eines Mammogramms zu beurteilen, könnten graue Wandfarbe und reduzierte Beleuchtung im Bildgebungsraum von Vorteil sein. Darauf deuten zumindest Ergebnisse einer kleinen Studie hin. 

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.