Panwar J, Mathew A, Thomas BP. Cystic lesions of peripheral nerves: Are we missing the diagnosis of the intraneural ganglion cyst? World J Radiol 2017; 9(5): 230-244 [PMID: 28634514 DOI: 10.4329/wjr.v9.i5.230]
Corresponding Author of This Article
Jyoti Panwar, MD, FRCR, Musculoskeletal Radiology Fellow, Joint Department of Medical Imaging, University Health Network, University of Toronto, 585 University Avenue, Toronto, Ontario M5G 2N2, Canada. drjyoticmch@gmail.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Basic Study
Open-Access Policy of This Article
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Table 3 Summery of magnetic resonance imaging findings of intraneural ganglion cyst of peripheral nerves
SN
Involved nerve
Extension
Labral or capsular tear
Joint abnormality
Muscledenervation
Anatomical extent along the parent nerve
Branches
Intra-articular extension
1
Right CPN
Upto sciatic bifurcation
Recurrent articular
Anterior aspect of PTF joint
Negative
-
Muscles of anterolateral compartment of leg
2
Left CPN
Upto posterolateral fibular head
Recurrent articular, deep peroneal
Anterior aspect of PTF joint
Negative
-
-
3
Right CPN
Upto sciatic bifurcation
Recurrent articular, superficial and deep peroneal
Anterior aspect of PTF joint
Negative
-
Muscles of anterolateral compartment of leg
4
Left CPN
Upto posterolateral fibular head
Recurrent articular, deep peroneal
Anterior aspect of PTF joint
Negative
-
-
5
Left CPN
Upto posterolateral fibular head
Recurrent articular, deep peroneal
Anterior aspect of PTF joint
Negative
-
Muscles of anterolateral compartment of leg
6
Right CPN
Upto posterolateral fibular head
Recurrent articular
Anterior aspect of PTF joint
Negative
-
Muscles of anterolateral compartment of leg
7
Right CPN
Upto neck of fibula
Recurrent articular
Anterior aspect of PTF
Negative
-
8
Right obturator
Along the lateral pelvic wall to pelvic brim
Anterior division
Anteromedial aspect of hip joint
Negative
-
Adductor brevis and magnus
9
Right suprascapular
Suprascapular to spinoglenoid notch
-
-
Negative
-
Supra and infraspinatus
10
Left proximal sciatic
At sciatic notch
Articular
Posteromedial aspect of hip joint
Negative
-
-
11
Right tibial
Upto tibial nerve
Articular, branch to popliteus muscle
Posterior aspect of PTF joint
Negative
-
-
12
Left tibial
Upto sciatic bifurcation
Articular, branch to popliteus muscle, branch to tibialis posterior muscle
Posterior aspect of PTF and knee joints
Negative
-
Popliteus and tibialis posterior
13
Right suprascapular
From the level of AC joint to below the spinoglenoid notch
Articular branch to AC joint
AC joint
Negative
-
-
Table 4 Magnetic resonance features differentiating intraneural ganglion cyst from extraneural ganglion cyst
Intraneural ganglion cyst
Extraneural ganglion cyst
Cyst size
Small
Large
Cyst shape
Tubular beaded configuration
Globular
Cyst pattern and location
It is along the course of the nerve and its branches with no fat plane between the cyst and the nerve
It does not follow the course of the nerve; the nerve is seen separately from the cyst with an intervening preserved fat plane; usually located in between the fibula and peroneus longus muscle, with or without an intramuscular extension
PTF joint connection
Is present and the tail lies anteromedial to proximal fibula between 10-12 o’clock position on axial MR images
Is present but located more superiorly and anterolateral to the proximal fibula at 12-2 o’clock position on axial MR images
Relation with fibula
The extension of the cyst along the articular branch appears to cross the fibula from medial to lateral (“Transverse limb sign”)
The cyst never crosses the fibula and always lies anterior, anterolateral or lateral to the fibula (Absent “Transverse limb sign”)
Muscle denervation
Common
Uncommon
Citation: Panwar J, Mathew A, Thomas BP. Cystic lesions of peripheral nerves: Are we missing the diagnosis of the intraneural ganglion cyst? World J Radiol 2017; 9(5): 230-244