Synovial cysts of the hip joint: a single-center experience

Abstract

BackgroundSynovial cyst of the hip joint is a rare clinical condition in need of evidence-based guidelines for its diagnosis and management. Normally, synovial cyst of the hip joint requires no treatment, but when it intrudes into surrounding structures, various clinical symptoms appear. Because of its rarity, a symptomatic synovial cyst is often confounded with a tumor as a space-occupying lesion or with other diseases, depending on its various clinical presentations. Therefore, guidelines for the precise diagnosis and appropriate management for synovial cyst of the hip joint are required.MethodsWe retrospectively studied 7 cases of symptomatic synovial cyst of the hip joint, some of which showed lower limb edema due to mass effect. We compared physical exam findings on presentation, imaging findings, and size and location of the cyst.ResultsAll cases were managed successfully with surgical excision. We found that, instead of the size of the cyst, the location of the cyst was an important contributor to venous compression. The recurrence rate was 0%, and some patients have significantly long follow-up of 2 years, 4 years, 6 years and 10 years, respectively.ConclusionsFor symptomatic synovial cyst of the hip joint, surgical excision can successfully resolve the symptoms without recurrence. This retrospective study discusses the clinical presentations, diagnostic approaches, and surgical treatment of symptomatic synovial cyst of the hip joint, hence shedding more light on the clinical management of this condition.

Bilateral giant hip cysts in a woman: an atypical presentation and a diagnostic challenge

“…In conclusion, given the rarity of the synovial cyst of the hip joint, more clinical literature is required to guide diagnosis and management. 10 A synovial cyst of the hip joint is usually unilateral, and our case represented the first in the literature of bilateral giant hip cysts, which highlighted the importance to consider such diagnosis in a patient with unexplained pain and oedema of bilateral extremities without prior history of trauma, surgery or any other disorders. A surgical approach should be considered to effectively relieve symptoms and complications from the cyst.…”

“…Also, treating the underlying pathology such as rheumatoid arthritis with prednisone and methotrexate can effectively relieve the symptoms. [8][9][10] However, when the patient develops significant complications due to compression onto the nerve, vein, artery or ureter by the enlarged cyst, invasive interventions are often required that include the options of needle puncture and aspiration or surgical resection. Surgical resection of the synovial cyst is effective to restore normal venous return and relieve symptoms subsequently.…”

“…A surgical approach should be considered to effectively relieve symptoms and complications from the cyst. 10…”

Giant Hip Synovial Cyst Causing Deep Vein Thrombosis and Femoral Head Osteonecrosis in a Rheumatoid Arthritis Patient

“…As far as the treatment of the cyst is concerned, total hip arthroplasty has been chosen in most cases in literature. 11 , 13 However, aspiration and drainage under ultrasound or CT guidance remains an option despite the higher chances of regression. 11 It has previously been reported that if the primary disease is RA, effective treatment may reduce the size of the cyst.…”