A modern perspective on the earliest description of an intraneural ganglion cyst arising from the knee joint

Spinner, Robert J.; Wang, Huan; Angius, Diana; Malik, Atiyatul G.; Amrami, Kimberly K.

doi:10.1002/ca.21063

Cited by 8 publications

(14 citation statements)

References 8 publications

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“…The cyst appearance and its joint connection are quite similar to that of a case published by our group. 151 The bony deformities from the patient's dwarfism are apparent (see also the case report by Choi and Kwon…”

Section: Etiologymentioning

confidence: 99%

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Intraneural ganglion cysts: a systematic review and reinterpretation of the world's literature

Desy

Wang²,

Elshiekh

et al. 2016

JNS

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113

134

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615 Literature review J Neurosurg 125:615-630, 2016I ntraneural ganglion cysts are benign mucinous lesions that are formed within peripheral nerves and typically lead to symptoms and signs of peripheral neuropathy. Their pathogenesis has been controversial. Different treatments have been recommended. Outcomes have been disappointing and the recurrence rate high and underreported.Over the past 15 years, our group has provided substantial evidence to support a unifying articular (synovial) theory as the etiology for all intraneural ganglion cysts. In 2003, the senior author (R.J.S.) demonstrated that the prototypical intraneural cysts of the common peroneal nerve are joint derived. Cyst formation originates in the superior tibiofibular joint (STFJ) and propagates toward abbreviatioNs EMG = electromyography; NCS = nerve conduction studies; STFJ = superior tibiofibular joint. obJective The etiology of intraneural ganglion cysts has been controversial. In recent years, substantial evidence has been presented to support the articular (synovial) theory for their pathogenesis. The authors sought to 1) perform a systematic review of the world's literature on intraneural cysts, and 2) reinterpret available published MR images in articles by other authors to identify unrecognized joint connections. methods In Part 1, all cases were analyzed for demographic data, duration of symptoms, the presence of a history of trauma, whether electromyography or nerve conduction studies were performed, the type of imaging, surgical treatment, presence of a joint connection, intraneural cyst recurrence, and postoperative imaging. Two univariate analyses were completed: 1) to compare the proportion of intraneural ganglion cyst publications per decade and 2) to assess the number of recurrences from 1914 to 2003 compared with the years 2004-2015. Three multivariate regression models were used to identify risk factors for intraneural cyst recurrence. In Part 2, the authors analyzed all available published MR images and obtained MR images from selected cases in which joint connections were not identified by the original authors, specifically looking for unrecognized joint connections. Two univariate analyses were done: 1) to determine a possible association between the identification of a joint connection and obtaining an MRI and 2) to assess the number of joint connections reported from 1914 to 2003 compared with 2004 to 2015. resuLts In Part 1, 417 articles (645 patients) were selected for analysis. Joint connections were identified in 313 intraneural cysts (48%). Both intraneural ganglion cyst cases and cyst recurrences were more frequently reported since 2004 (statistically significant difference for both). There was a statistically significant association between cyst recurrence and percutaneous aspiration as well as failure to disconnect the articular branch or address the joint. In Part 2, the authors identified 43 examples of joint connections that initially went unrecognized: 27 based on their retrospective MR image reinterpretation o...

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Section: Etiologymentioning

confidence: 99%

“…The use of arthrography also demonstrated the direct communication between neighboring joint and intraneural cyst in all patients who received this study. 28,30,44,72,80,96,119,139,141,142,144,145,148,151,152 However, despite 5. Previously reported case, which on reinterpretation by our group, demonstrates a joint connection.…”

Section: Etiologymentioning

confidence: 99%

Intraneural ganglion cysts: a systematic review and reinterpretation of the world's literature

Desy

Wang²,

Elshiekh

et al. 2016

JNS

Self Cite

113

134

View full text Add to dashboard Cite

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“…Once considered curious entities, they are now well characterized. [1][2][3] The use of high-resolution imaging in patients with these cysts has led to further understanding of the pathogenesis. A joint connection is a constant finding, and imaging patterns are described on the basis of this anatomical connection.…”

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confidence: 99%

High-resolution MRI of a peroneal intraneural ganglion cyst arising from the knee joint: illustrative case

Smith¹,

Jack²,

Powell

et al. 2021

Journal of Neurosurgery: Case Lessons

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BACKGROUND The advancement of high-resolution imaging and increased clinical experience have led to an increased understanding of the formation and treatment of intraneural ganglion cysts. Nearly all intraneural ganglion cysts in the common peroneal nerve have been reported to arise from a joint connection to the superior tibiofibular joint. The authors have identified four cases of intraneural ganglion cysts arising from the knee joint itself; however, none of these reported cases were well described, documented, or illustrated with high-resolution imaging. OBSERVATIONS Here the authors present the case of an intraneural ganglion cyst arising from the knee joint and causing intermittent weakness and pain. The articular branch to the knee joint was clearly demonstrated on high-resolution magnetic resonance imaging and confirmed at surgical exploration. The patient was treated with articular branch ligation and has had complete resolution of his symptoms without recurrence of the cyst on follow-up imaging. LESSONS This case adds to the mounting evidence that intraneural cyst pathology is dependent on a connection to a synovial joint as stated in the unifying theory of intraneural cyst development.

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“…Synovial fluid from a capsular defect dissects along the epineurium of an articular nerve branch through the path of least resistance into a major parent nerve 2–4 . The vast majority of intraneural ganglion cysts originate from the superior tibiofibular joint and extend into the common peroneal nerve 2,5 . Tibial nerve involvement is extremely rare with only a handful of reports in the literature 2,6–8 …”

Section: Figmentioning

confidence: 99%

Unusual case of an intraneural ganglion cyst of the tibial nerve

Wang

Hui

Campbell

et al. 2021

ANZ Journal of Surgery

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A modern perspective on the earliest description of an intraneural ganglion cyst arising from the knee joint

Cited by 8 publications

References 8 publications

Intraneural ganglion cysts: a systematic review and reinterpretation of the world's literature

Intraneural ganglion cysts: a systematic review and reinterpretation of the world's literature

High-resolution MRI of a peroneal intraneural ganglion cyst arising from the knee joint: illustrative case

Unusual case of an intraneural ganglion cyst of the tibial nerve

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