Intraneural ganglion cysts of obturator nerve causing obturator neuropathy

Sureka, Jyoti; Panwar, Sanuj; Mullapudi, Indira

doi:10.1007/s13760-012-0041-1

Cited by 6 publications

(7 citation statements)

References 3 publications

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“…The hip joint is innervated by several peripheral nerves and INGCs of these nerves through their articular branches have been reported 2‐10 . However, characteristics of INGCs around the hip joint have not been adequately described because of the scarcity of cases.…”

Section: Introductionmentioning

confidence: 99%

Intraneural ganglion cysts originating from the hip joint: A single‐center experience

2022

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Introduction/Aims Intraneural ganglion cysts (INGCs) are non‐neoplastic mucinous cysts within the epineurium of peripheral nerves. Characteristics of INGCs around the hip joint have not been adequately described. We aimed to describe clinical features, imaging findings, and treatment outcomes in patients with INGCs originating from the hip joint. Methods We retrospectively included cystic lesions around the hip joint satisfying the following inclusion criteria over 6 years: (1) multilocular elongated hyperintense cystic mass on T2‐weighted imaging; and (2) distribution along the course of the peripheral nerve and its branches on magnetic resonance imaging (MRI). Results Six patients with an INGC around the hip joint were identified. Parent peripheral nerves were the sciatic nerve (four patients), the superior gluteal nerve (one patient), and the nerve to quadratus femoris (one patient). Buttock, groin, or lower extremity pain/paresthesias were the initial symptoms in all patients. INGCs within the articular branches of the hip joint were identified on MRI. Four patients underwent arthroscopic debridement and capsulotomy. All patients showed generally favorable outcome regardless of treatment. Discussion Physicians should consider the possibility of INGCs originating from the hip joint as a cause of nontraumatic hip, buttock, or lower extremity pain. This can occur in any nerve innervating the hip joint, and usually it originates in the posterior capsule of the hip joint. Arthroscopic surgery shows promising results; however, more information about the surgical technique and long‐term follow‐up results are needed.

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Section: Introductionmentioning

confidence: 99%

Intraneural ganglion cysts originating from the hip joint: A single‐center experience

2022

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“…In Spinner’s series of INGC around the hip and pelvic region[44], four out of five cases showed a cyst at the sciatic notch with an articular communication with the ipsilateral hip joint and further extension of the same into the sciatic nerve. Likewise, the obturator INGC also has a known joint connection with the anteromedial hip joint[44,45] as seen in our case. The propagation of the cyst along the articular branch and further dissection of the cyst along the parent nerve and its anterior and posterior branches has been described[45] and is demonstrated in the current case.…”

Section: Discussionmentioning

confidence: 53%

“…Likewise, the obturator INGC also has a known joint connection with the anteromedial hip joint[44,45] as seen in our case. The propagation of the cyst along the articular branch and further dissection of the cyst along the parent nerve and its anterior and posterior branches has been described[45] and is demonstrated in the current case. Variable atrophy and denervation hyperintensity of ipsilateral adductor brevis and magnus muscles was also seen in our case.…”

Section: Discussionmentioning

confidence: 53%

Cystic lesions of peripheral nerves: Are we missing the diagnosis of the intraneural ganglion cyst?

Panwar

Mathew

Thomas

2017

WJR

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AIMTo highlight the salient magnetic resonance imaging (MRI) features of the intraneural ganglion cyst (INGC) of various peripheral nerves for their precise diagnosis and to differentiate them from other intra and extra-neural cystic lesions.METHODSA retrospective analysis of the magnetic resonance (MR) images of a cohort of 245 patients presenting with nerve palsy involving different peripheral nerves was done. MR images were analyzed for the presence of a nerve lesion, and if found, it was further characterized as solid or cystic. The serial axial, coronal and sagittal MR images of the lesions diagnosed as INGC were studied for their pattern and the anatomical extent along the course of the affected nerve and its branches. Its relation to identifiable anatomical landmarks, intra-articular communication and presence of denervation changes in the muscles supplied by involved nerve was also studied.RESULTSA total of 45 cystic lesions in the intra or extraneural locations of the nerves were identified from the 245 MR scans done for patients presenting with nerve palsy. Out of these 45 cystic lesions, 13 were diagnosed to have INGC of a peripheral nerve on MRI. The other cystic lesions included extraneural ganglion cyst, paralabral cyst impinging upon the suprascapular nerve, cystic schwannoma and nerve abscesses related to Hansen’s disease involving various peripheral nerves. Thirteen lesions of INGC were identified in 12 patients. Seven of these affected the common peroneal nerve with one patient having a bilateral involvement. Two lesions each were noted in the tibial and suprascapular nerves, and one each in the obturator and proximal sciatic nerve. An intra-articular connection along the articular branch was demonstrated in 12 out of 13 lesions. Varying stages of denervation atrophy of the supplied muscles of the affected nerves were seen in 7 cases. Out of these 13 lesions in 12 patients, 6 underwent surgery.CONCLUSIONINGC is an important cause of reversible mono-neuropathy if diagnosed early and surgically treated. Its classic MRI pattern differentiates it from other lesions of the peripheral nerve and aid in its therapeutic planning. In each case, the joint connection has to be identified preoperatively, and the same should be excised during surgery to prevent further cyst recurrence.

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“…It causes motor weakness, sensory changes or pain due to compression of the affected nerve. [1][2][3] Although intraneural ganglion cysts usually arise near the joints, cysts in the pelvic region involving the obturator nerve with a connection to the hip joint have been reported. 4 In this case, a ganglion involving the obturator nerve was not connected to the hip joint.…”

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confidence: 99%

“…It presents as unilocular or septated cysts filled with translucent mucin. It causes motor weakness, sensory changes or pain due to compression of the affected nerve . Although intraneural ganglion cysts usually arise near the joints, cysts in the pelvic region involving the obturator nerve with a connection to the hip joint have been reported .…”

mentioning

confidence: 99%