MRI of the foot and ankle: Prevalence and distribution of occult and palpable ganglia

Abstract

The purpose of this study was to evaluate the prevalence and anatomic distribution of occult and palpable ganglia of the foot and ankle as seen by MRI. Within a 7-year period MRI of the ankle was performed on 2813 patients, and MRI of the foot on 2277 patients using a 1.5T magnet. In all, 167 ganglia in 155 patients were detected. MR images of these patients were reviewed retrospectively by two observers with regard to prevalence, imaging characteristics, and exact anatomic location of ganglia. Clinical findings and (when available) surgical reports were also reviewed. One hundred fifty-seven ganglia in 145 patients were present on MR images of the ankle, and 10 ganglia in 10 patients on MR images of the foot, resulting in a prevalence of 5.6% ( Index terms: magnetic resonance imaging; foot; ankle; ganglia; benign soft-tissue tumors A GANGLION IS A MYXOID CYSTIC LESION arising in association with periarticular and articular structures, tendon sheaths, and, less frequently, with muscle or periosteum (1). MRI has been shown to be useful in identifying ganglia (2-5).The majority of patients with ganglia of the foot and ankle present either with a palpable mass as the only symptom (6), or with the lesion as an incidental finding on MR images. However, a small subset of ganglia of the foot and ankle may cause symptoms such as discomfort or pain, and entrapment neuropathies (6,7).After the hand and wrist, the foot and ankle are considered the second most common location of ganglia (6). Although ganglia of the foot and ankle are reported to be common, little attention has been focused on the prevalence and anatomic distribution of these lesions (6 -8).Consequently, the purpose of this study was to determine the prevalence and distribution of both occult and palpable ganglia of the foot and ankle. PATIENTS AND METHODS PopulationBetween February 1992 and October 1999, 2813 patients underwent MRI of the ankle, and 2277 patients underwent MRI of the forefoot at our institution. All patients were referred for evaluation of foot or ankle pain or evaluation of a soft-tissue mass. The patients were mainly referred by orthopedic foot surgeons and sports medicine physicians. The radiological reports of all these patients were reviewed for the presence of ganglia. A total of 167 ganglia in 159 feet of 155 patients (87 women and 68 men, mean age: 44.5 years; range: 9 -71 years) were described in the reports of these studies. The MRIs of all these patients were retrospectively reviewed. MRIAll MRIs were performed with a 1.5 T MR scanner (Signa EchoSpeed or Signa Horizon LX; GE Medical Systems, Milwaukee, WI). An extremity coil was used for imaging all patients (field of view: 12-20 cm). MRI protocol of the ankle included T1-weighted spin-echo (SE) and fast SE (FSE) short inversion time inversion-recovery (STIR) sequences in the sagittal plane, T1-weighted SE and T2-

Ultrasound-Guided Ganglion Cyst Aspiration

“…Soft-tissue ganglia are most commonly encountered about the wrist; however, they can be seen through the musculoskeletal system with a 0.4% prevalence reported in the foot based on magnetic resonance imaging data [1]. Of these, the most common location is usually the tarsal sinus or tarsal canal, with the second most common location about the Lisfranc joint [1].…”

“…Of these, the most common location is usually the tarsal sinus or tarsal canal, with the second most common location about the Lisfranc joint [1].…”

MR Imaging of Soft-Tissue Masses of the Foot

“…In the foot, ganglia are most frequently seen in the sinus tarsi followed by the dorsum of the foot. 19 On MRI, the lesions are low to intermediate in signal intensity on T1weighted images (Fig. 1A), increase in signal intensity with T2-weighted sequences (Fig.…”

Akute Sportverletzungen und chronische Überlastungsschäden an Vor- und Mittelfuß

“…Ätiologisch werden repetitive Traumen und chronische Überbelastungen diskutiert [4,23]. Vor-und Mittelfuß stellen im Gegensatz zu Rückfuß und Sprunggelenkregion seltenere Lokalisationen von Ganglien dar [24]. Ihre bevorzugte Position liegt dorsal der Extensorensehnen [4].…”