Intraosseous Ganglion Cyst Research Articles

Intraosseous Ganglion Cyst of the Talus Treated With Curettage and Bone Grafting Through a Medial Malleolus Osteotomy.

Intraosseous ganglion cyst (IGC) of the talus is a rare entity. There is no consensus regarding the best surgical approach to the talus. In this study, we evaluated the outcomes of curettage and bone grafting of the talus IGC via medial malleolus osteotomy. Seventeen patients with talus IGC who were treated between 2002 and 2020 using curettage and bone grafting through a medial malleolus osteotomy were included. The outcome measures were ankle range of motion (ROM), pain, and function. The ankle pain was evaluated by the visual analog scale (VAS). The ankle function was evaluated by the Toronto extremity salvage score (TESS) and Musculoskeletal Tumor Society (MSTS) score. The study population included 10 men and 7 women with a mean age of 34.9 ± 18.8 years and a mean follow-up of 5.4 ± 3 years. The mean size of the lesion was 2.6 ± 0.8 cm. Postoperatively, mean ankle dorsiflexion and plantar flexion were 19.4 ± 5.8 degrees and 36.7 ± 5.3 degrees, respectively. The mean VAS was 0.9 ± 1.1. The mean MSTS score and TESS were 96.2 ± 3.5 and 94.5 ± 4.1, respectively. Two patients developed ankle osteoarthritis after 3 years (1 stage I and 1 stage II). One of these patients (stage II) also had recurrence after 6 months (recurrence rate: 6.7%). Talus IGC could be adequately managed with curettage and bone grafting through a medial malleolus osteotomy. Even so, mild pain and reduced ankle ROM remain in some patients. Level IV, retrospective cohort study.

Diagnosis and Treatment of Intraosseous Ganglion in the Ankle Region.

To investigate the diagnosis and treatment of intraosseous ganglion cyst in the ankle region. A retrospective analysis was performed on the diagnosis and treatment of 18 patients with intraosseous ganglion in the ankle region from January 2005 to March 2016. There were 11 males and 7 females, with an average age of 40.4 years (22-74 years). Thirteen of these had mild intermittent localized pain in the ankle and five were asymptomatic and fortuitously found on images. According to the location of the intraosseous ganglion cyst, nine were located in the distal end of tibia, seven were in the distal end of the fibula, and two were in the talus. After curettage of intraosseous ganglion, 15 cases were filled with autogenous iliac bone and 3 cases with artificial bone. Fifteen cases were diagnosed with radiographs and CT scans, two cases with MR images, and one case was confirmed by postoperative pathology. The cyst contents were jelly-like material with sclerotic bone margins. The mean size of the intraosseous ganglion cyst was 1.5cm × 1.5cm × 1cm. Hematoxylin and eosin (H&E) staining of the tissue showed fibrous tissue, collagenous fiber, mucoid, and a few fibroblasts. Eighteen cases were followed up for 11 months to 10 years, with an average of 5.4 years. No recurrence was found. Sixteen patients were asymptomatic after surgery. Two cases of ankle pain occurred at 1 year and 6 months postoperatively, respectively. According to the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale, the mean AOFAS ankle-hindfoot score improved from 78.2±13.7 points preoperatively to 97.3±4.5 points at the final follow-up. For the intraosseous ganglion cyst in the ankle region, whether there are clinical symptoms or not, the cyst should be curettaged and the cavity should be filled with bone graft. The operation result is satisfactory.

Recurrent intraosseous spindle myoepithelioma of the distal fibula: A clinical and radiological challenge

A 42-year-old man with a past history of lipomas, presented with right ankle pain radiating to the hip and limited range of motion of the ankle. An initial XR was performed revealing an expansile lytic lesion in the right distal fibula. Next, an MRI was performed to confirm this expansile lytic lesion. Initial presumptive differential diagnoses included chondromyxoid fibroma, osteoblastoma, intraosseous ganglion cyst and Brodie’s abscess. However, upon bone biopsy the pathology report revealed that the lesion was smooth muscle actin (SMA) positive and an ultimate diagnosis of intraosseous spindle myoepithelioma (ISM) was made. Curettage was then performed on the initial lesion to excise the tumor. The patient since has had multiple recurrences of this lesion. The diagnosis of ISM is rare and can present with many challenges in diagnosis radiologically and clinically as this tumor can mimic many common diagnoses. Due to the paucity of literature on this topic, documentation of this case will help enhance the understanding of this rare lesion, its behavior, and possible genetic associations.

Intraosseous Ganglion Cyst of the Sternoclavicular Joint

Summary:We report the case of a 63-year-old man who presented with a mass on the right clavicle near the sternoclavicular joint. He had received prior puncturing treatment, but relapsed each time. Magnetic resonance imaging revealed that the mass was a ganglion cyst, which appeared to be connected to the right clavicle. Excisional biopsy revealed that the cyst was an intraosseous ganglion cyst, and the cavity was connected to the sternoclavicular joint. The cavity was filled with an artificial bone graft after curettage to prevent fracture. Histological examination showed that the cyst wall had no lining cells and consisted of fibrous connective tissue. To the best our knowledge, this case is the first report of an intraosseous ganglion cyst of the sternoclavicular joint.

Treatment of Intraosseous Ganglion Cyst of the Lunate: A Systematic Review.

Intraosseous ganglion cyst (IGC) is a rare disease, particularly in lunate. The objective of this study was to summarize current knowledge on the treatment of IGC of the lunate, through a literature review, to provide a therapeutic strategy for this rare disease. The PubMed, ISI Web of Science, Cochrane Library, EMBASE, Science Direct database were searched with a set of predefined inclusion and exclusion criteria. Manual searches for references were performed to find potential relevant studies. The authors extracted data from the articles selected. Different treatment modalities of IGC of the lunate were described, all of which were divided into 3 categories: conservative treatment, classical surgical procedures, and novel surgical procedures. An overview on the main treatment modalities for IGC of the lunate was provided. Conservative treatments can be the doctors' first choice for patients with IGC. Surgical procedure is advised when conservative treatment fails. Traditional surgical curettage with autologous bone grafting is the mainstay of treatment with satisfactory outcomes; however, novel surgical techniques like arthroscopically assisted minimally invasive technique or filling with bone cement are considered as more promising attempts with less trauma and shorter recovery period. Nonetheless, studies with high levels of evidence are guaranteed for developing widely accepted clinical treatment guidelines.

Intraosseous ganglion cyst of the distal tibia in a young male patient

The case of a 25-year-old man with a ganglion cyst of the medial aspect of the ankle has been presented. Biopsy was taken during the surgery and sent for histopathology, which showed cystic area lacking epithelial lining filled with mucoid material. The patient was treated with curettage of the medial malleolus.

A rare cause of ulnar-side wrist pain: Ganglion cyst of the triquetrum

Diagnosing chronic wrist pain may sometimes be challenging and the differential diagnoses include many conditions (traumatic, rheumatoid, neoplasms, etc.). This report describes a case of chronic wrist pain due to intraosseous ganglion cyst of triquetrum. The wrist pain had lasted for 6 months and was not relieved by conservative treatment. Magnetic resonance imaging revealed an intraosseous ganglion cyst. The triquetrum was tender on palpation. After curettage and grafting of the cyst, and 6 months of follow-up, the patient was free of complaints with full range of motion of the wrist. Although mostly asymptomatic, intraosseous ganglion cysts should be kept in mind when assessing wrist pain.

A pathological fracture of the scaphoid revealing an intraosseous ganglion cyst

Intraosseous ganglion cyst is a benign bone lesion with histological similarities to the soft tissue ganglion cyst. Its location on the short bones, including the carpal bones has rarely been reported. The radiolucent carpal lesions are usually symptom-free found incidentally on radiographs of the wrist performed for other reasons. Detecting a pathological fracture of the scaphoid revealing an intraosseous ganglion cyst is exceptional. We report the case of a 21-year-old, right-handed male, presented with a one year history of progressive right-wrist pain, worsened since a month without a history of previous trauma. Plain radiographs and CT-scan revealed a cystic lesion of the scaphoid with a pathological fracture. He was successfully treated with curettage and packing with a Zaidemberg's vascularized radial graft without recurrence at two years postoperatively. Pan African Medical Journal 2016; 23

Arthroscopic Treatment of Intraosseous Ganglion Cyst of the Lunate Bone

Intraosseous ganglion cysts are rare causes of wrist pain. Surgical treatment of this pathologic condition yields good results and a low recurrence rate. The main complications are joint stiffness and vascular disturbances of the lunate bone. Wrist arthroscopy is a surgical technique that reduces the intra-articular operative area and therefore minimizes postoperative stiffness. This article describes an arthroscopic technique used for lunate intraosseous cyst resection associated with an autologous bone graft in a series of cases to prevent joint stiffness while respecting the scapholunate ligament. This study was based on a series of 4 patients, all of whom had wrist pain because of intraosseous ganglion cysts. Arthrosynovial cyst resection, ganglion curettage, and bone grafting were performed arthroscopically. Pain had totally disappeared within 2 months after the operation in 100% of patients. The average hand grip strength was estimated at 100% compared with the opposite side, and articular ranges of motion were the same on both sides in 100% of cases. No complications were reported after surgery. On the basis of these results, arthroscopic treatment of intraosseous synovial ganglion cysts seems to be more efficient and helpful in overcoming the limitations of classic open surgery in terms of complications.

Intraosseous ganglion cyst of scaphoid: A case report

Background: Intraosseous ganglion cysts are rare causes of hand and wrist pain. Differential diagnosis of painful cystic radiolucent carpal lesions includes osteoid osteoma and osteoblastoma. Isolated cases of ganglion cysts occurring in the lunate, scaphoid, pisiform, hamate, triquetrum, capitate, metacarpal, and phalanx have been reported. Case Presentation: A case of intra-articular intraosseous ganglion cyst of the scaphoid is presented. A 32-year-old right-handed man presented with a 2 year history of progressive left-wrist pain. No history of trauma was reported. Conservative treatment with anti-inflammatory medications before referral was unsuccessful. This case was treated with curettage and bone grafting having excellent results with visual and analog pain scores reduced from 68 to 11 and range of motion was 90° extension to 80°flexion and full grip strength. Conclusion: Cases of intraosseous ganglions are reported in literature mostly in lower limbs and lunate among carpals, with scaphoid being a rare site of the involvement. In this report, we described a symptomatic case which was successfully treated by intralesional curettage, and autogenous bone grafting.

Intraosseous Ganglion Cyst of the Lunate

Intraosseous Ganglion Cyst of the Lunate

Intraosseous ganglion cyst within the L4 lamina causing spinal stenosis

There are rare reports of intraosseous ganglion cysts in the cervical spine. However, to our knowledge, there are no previous reports of these cysts occurring in the lumbar spine. To report a case of symptomatic lumbar spinal stenosis caused by an intraosseous ganglion cyst of the L4 lamina that communicated with the spinal canal. Case report. An 86-year-old woman was referred to our spine service for a 2-year history of anterior thigh and leg pain. Magnetic resonance imaging revealed a benign-appearing intraosseous cyst in the left L4 lamina communicating with a posterior epidural cyst at L4-L5 causing marked spinal stenosis. The patient was treated successfully with a laminectomy and resection. The patient underwent partial laminectomies of L4 and L5 preserving the interspinous ligaments between L5-S1 and L3-L4. The cyst was removed en bloc without violation of the cyst wall. Histopathologic examination revealed focal myxoid changes without a cellular lining of the cyst wall, confirming the diagnosis of intraosseous ganglion cyst. This is the first report to describe an intraosseous ganglion cyst occurring in the lumbar spine. Although spinal stenosis is commonly a result of degenerative joint or disc disease, it occasionally may result from more obscure causes. This case illustrates a patient with an intraosseous ganglion cyst within the spinal lamina resulting in spinal stenosis, treated successfully with a laminectomy and resection.

Kystes synoviaux intraosseux du carpe : intérêt de la tomodensitométrie systématique pour l’évaluation du risque fracturaire

The intraosseous ganglion cyst (IOGC) is a benign and lytic bone tumor affecting mostly the metaphyseal and epiphyseal regions of long bones. Its location on the short bones, including the carpal bones has been little reported in the literature. Our review of the literature shows consensus about the surgical techniques to use, but there is currently no real consensus about its pathophysiology, and its diagnostic work-up. Complications related to this lesion (mainly the risk of pathologic fracture) are potentially serious, and can cause irreversible damage. They therefore require accurate assessment to guide the choice of medical or surgical treatment, including a CT scan, which — we believe — is essential.

Kyste synovial intraosseux du capitatum : à propos d’un cas

Intraosseous cyst of the carpal bones is a rare cause of wrist pain. Few cases have been reported. We report a rare case of intraosseous ganglion cyst of the capitate, in a girl aged 16 who plain of chronic pain of the right wrist. The radiological assessment showed an osteolytic lesion with marginal sclerosis. The diagnosis was confirmed by histopathology and treatment consisted of curettage with autologous cancellous bone graft. At 8 months follow-up, the capitate is fully consolidated and the functional result is satisfactory.

A rare case of intraosseous ganglion of the triquetrum

Carpal intraosseous ganglia are one of the rarely seen pathologic conditions in the hand. In this report we present a rare case of an intraosseous ganglion cyst in a 16-year-old girl located in the triquetrum bone as an uncommon cause of wrist pain. Radiographic and magnetic resonance imaging demonstrated the cystic lesion into the triquetrum. The patient was successfully treated by excision of the ganglion cyst and curettage of the bone. Clinical aspects, radiological findings and treatment modalities of this condition were briefly reviewed.

Mucoid degeneration of the anterior cruciate ligament: MRI, clinical, intraoperative, and histological findings

To describe the clinical, MRI, intraoperative, and histological features of mucoid degeneration of the anterior cruciate ligament (ACL). This study included 10 patients (average age 47years, range 19-69years) who underwent surgery due to clinical diagnoses of mucoid degeneration of the ACL. All patients underwent preoperative magnetic resonance imaging (MRI) and were arthroscopically treated. All 10 patients reported preoperative posterior knee pain. MRI indicated a thickened ACL with increased signal on all sequences. Postoperatively, only six of 10 patients were confirmed by biopsy to have a mucoid degeneration of the ACL. An associated intraosseous tibial cyst or ganglion was observed only in patients with a definitive diagnosis of mucoid degeneration. Mucoid degeneration of the ACL can be suspected in patients with posterior knee pain associated with a thickened ACL. Associated findings such as an intraosseous tibial or ganglion cyst help to rule out differential diagnosis.

Bilateral Lunate Intraosseous Ganglia

An intraosseous ganglion is a relatively uncommon, benign cystic lesion that occurs in young and middle-aged adults. Bilateral and symmetrical lesions of the wrist are rare. Intraosseous ganglia of the carpal bones are uncommon causes of chronic wrist pain. Isolated cases of intraosseous ganglion have been reported most commonly in the lunate and scaphoid. The lunate was most frequently affected, followed by the capitate, scaphoid, and triquetrum bones. Radiolucent lesions in the carpal bones are not uncommon and are often seen incidentally in asymptomatic patients. The differential diagnosis of a lytic lesion in a carpal bone includes unicameral bone cyst, degenerative cyst, fibrous developmental defect, osteomyelitis, and intraosseous ganglion cyst. This article describes a case of bilateral lunate intraosseous ganglia. A review of the literature revealed that bilateral and symmetrical intraosseous ganglia of the wrist are rare, with only 3 other reported cases of bilateral lunate lesions.

Ganglion cyst of the carpal navicular. A case report and review of the literature

Intraosseous ganglion (IOG) cyst of the scaphoid is an infrequent cause of hand and wrist pain. Intraosseous ganglia located in the scaphoid have rarely been described in the literature. We report the case of a 30-year-old right-handed woman who presented with a more than 24-month history of progressive right-wrist pain. No history of trauma was reported.Conservative treatment with anti-inflammatory medications before referral was unsuccessful. Examination revealed a small palpable mass in the carpal navicular region with no limitation of normal wrist motion. An IOG cyst of the scaphoid was found on standard radiograph and CT-scan of the wrist. Treatment consisted in curettage of the cyst followed by packing of the defect with autologous cancellous bone graft harvested in the distal end of the radial metaphysis. Satisfactory functional recovery was achieved. The clinical, radiographic and therapeutic aspects of this rare condition are discussed by the authors.

The Use of Medulloscopy for Localized Intramedullary Lesions: Review of 5 Cases

We report 5 cases of a localized lesion (4 with osteomyelitis and 1 with an intraosseous ganglion cyst) that were treated successfully by medulloscopy. Medulloscopy is a standard arthroscopic technique for visualizing the intramedullary canal of the tibia. Two portals were created to allow easy access and triangulation to the lesion, one for the 5-mm arthroscope and the other for the instrument. Debridement, irrigation, and resection of the sequestrum were performed for the cases with osteomyelitis, and the intraosseous ganglion cyst was treated with biopsy, debridement, and autogenous bone grafting. All cases were treated successfully with medulloscopy and did not show recurrence at the last follow-up. In addition, there were no complications related to the procedure.

TREATMENT OF INTRAOSSEOUS GANGLIA AND BONE CYSTS OF THE CARPAL BONES WITH INJECTABLE CALCIUM PHOSPHATE BONE CEMENT

This article documents the outcome of treatment of intraosseous ganglia and simple bone cysts of the carpal bones by curettage and injectable calcium phosphate bone cement (CPC) grafting. The patients consisted of five men and three women. One had a cystic lesion in the scaphoid, one in the hamate, and five in the lunate. Curettage of the lesions was performed, and CPC was injected into the cavity. Five patients were diagnosed with a ganglion and three with a simple bone cyst. Among the five patients with wrist pain, the pain disappeared completely in four. Radiographs showed apparent partial absorption of CPC in four patients and no absorption in other four. There were no recurrence of tumours and no other complications were encountered. We conclude that calcium phosphate bone cement is a useful material for repairing bone defect after curettage of an intraosseous ganglion or bone cyst of a carpal bone.