ganglion cysts

Cyst-like
lesions around the knee • Hoffa's fat pad ganglion cyst - Ganzer Fall bei Radiopaedia
ElBeialy, M. Hoffa's fat pad ganglion cyst. Case study, Radiopaedia.org. (accessed on 13 Nov 2022) https://doi.org/10.53347/rID-25849 • CC by-nc-sa 3.0 (modified)
MRI
characteristics of cysts and “cyst-like” lesions in and around the knee: what the radiologist needs to know. Common peroneal nerve sheath ganglion cyst. The axial (a) T1-weighted, (b) contrast-enhanced fat saturated T1-weighted, (c) fat saturated proton density weighted images and two sequential coronal (d, e) fat saturated proton density weighted images show a cystic lesion (arrows) at the lateral aspect of the fibula head extending caudally
insightsimaging.springeropen.com • Open Access
MRI
characteristics of cysts and “cyst-like” lesions in and around the knee: what the radiologist needs to know. Hoffa’s fat pad ganglion cysts: the sagittal (a) and axial (b) fat saturated proton density weighted images in two different patients demonstrate a multiloculated septated cystic lesion (asterisks) within the Hoffa’s fat pad. Ganglion cyst of the suprapatellar bursa: the sagittal (a) and axial (b) fat saturated T2-weighted images show a lobulated cystic lesion (arrows) in the suprapatellar bursa
insightsimaging.springeropen.com • Open Access
Lesions
involving the outer surface of the bone in children: a pictorial review. Ganglion cyst at the lateral margin of the right knee in a 6-year-old boy. An AP radiograph of the right knee a reveals slight soft-tissue fullness along the lateral aspect of the knee (marked by star). This corresponded to the site of fluctuant mass noted on palpation. No associated adjacent bony defects/erosive changes are observed. Axial b and coronal c fat-suppressed T2-weighted MR images show a lobulated, deformable, cystic mass adjacent to and wrapping around the lateral distal femoral metaphysis (arrows). A sagittal proton density image d reveals high signal within the fluid (due to high mucopolysaccharide content); thin rim enhancement was noted with contrast (arrow) e
insightsimaging.springeropen.com • Open Access
MRI
characteristics of cysts and “cyst-like” lesions in and around the knee: what the radiologist needs to know. Intraosseous ganglion cyst. The axial (a) and coronal (b) fat saturated proton density weighted images demonstrate a solitary, unilocular cystic lesion (arrows). Note the sclerotic rim (arrowheads) and mild reactive bone oedema (asterisk)
insightsimaging.springeropen.com • Open Access
MRI
characteristics of cysts and “cyst-like” lesions in and around the knee: what the radiologist needs to know. Extra-articular ganglion cysts. The axial (a) and sagittal (b) fat saturated proton density weighted images demonstrate a unilocular cystic fluid collection consistent with an extra-articular ganglion cyst (arrows). The coronal (c) and sagittal (d) fat saturated proton density weighted images show a multilocular extra-articular ganglion cyst (arrows)
insightsimaging.springeropen.com • Open Access
MRI
characteristics of cysts and “cyst-like” lesions in and around the knee: what the radiologist needs to know. PCL ganglion cyst. The sagittal (a) and axial (b) fat saturated proton density weighted images show a multiloculated septated cyst (arrowheads) located in contact with the PCL (white arrows) and along its dorsal surface. Note a small insertional tibial cyst (black arrow)
insightsimaging.springeropen.com • Open Access
MRI
characteristics of cysts and “cyst-like” lesions in and around the knee: what the radiologist needs to know. Ganglion cyst of the proximal tibiofibular joint. The coronal fat saturated proton density weighted image shows a ganglion cyst (white arrow) emerging with a short neck (black arrow) from the proximal tibiofibular joint (T tibia, F fibula)
insightsimaging.springeropen.com • Open Access
Cyst-like
lesions around the knee • Intra-articular ganglion cyst - knee - Ganzer Fall bei Radiopaedia
Schubert, R. Intra-articular ganglion cyst - knee. Case study, Radiopaedia.org. (accessed on 13 Nov 2022) https://doi.org/10.53347/rID-17149 • CC by-nc-sa 3.0 (modified)
Spectrum of
MRI features of ganglion and synovial cysts. a, b. Ganglion cyst in the volar aspect of the wrist in a 55-year-old woman presenting with pain during volar flexion and paresthesia. Axial FS PD-weighted MRI (a) shows a smooth, multiloculated, homogeneously hyperintense lesion located deep and medial to the radial artery (arrow) and lateral to the flexor pollicis longus (dashed arrow) and the flexor carpi radialis (arrowhead) tendons. A tiny amount of fluid within the abductor pollicis longus and extensor pollicis brevis tendinous sheath (asterisk) is also present. The site of origin of the cyst is more evident on the sagittal T2-weighted MRI (b), which seems to originate more distally in the radioscaphoid interval (arrow). Rd, radius; Sc, scaphoid. Case courtesy of Dr. Carlos Teiga. Radiology Department, Centro Hospitalar de Lisboa Central. Lisbon, Portugal
insightsimaging.springeropen.com • Open Access
Spectrum of
MRI features of ganglion and synovial cysts. A giant synovial cyst incidentally found in the right hip of a 67-year-old woman during a routine computed tomography scan in the follow-up of a colorectal cancer in complete remission. For better characterization of the lesion, MRI was performed. Sagittal PD-WI shows a smooth, large multiloculated cyst, communicating with the joint space through a stalk (arrow). The lesion, probably corresponding to an enlarged iliopsoas bursa, displaces anteromedialy the iliopsoas muscle, and despite its close contact with the iliac bone, any erosion is seen. Ip, iliopsoas; IB, iliac bone
insightsimaging.springeropen.com • Open Access
Pseudotumoural
soft tissue lesions of the hand and wrist: a pictorial review. Small dorsal ganglion cyst. a Axial FS T2-WI. Note a well-delineated hyperintense structure at the dorsal aspect of the wrist (arrow). b The coronal FS TSE T2-WI shows a fluid-filled tear at the scapholunate ligament (arrow)
insightsimaging.springeropen.com • CC-by-2.0
Pseudotumoural
soft tissue lesions of the hand and wrist: a pictorial review. Volar ganglion cyst. a Coronal FS T2-WI. Note a polylobular hyperintense cystic structure with a small stalk-like connection to the adjacent scaphotrapezial joint (arrow). b Axial FS T2-WI. The cyst is well delineated and is of high signal intensity (arrowheads)
insightsimaging.springeropen.com • CC-by-2.0
Pseudotumoural
soft tissue lesions of the hand and wrist: a pictorial review. Volar ganglion cyst. Longitudinal ultrasound showing a well-defined anechoic structure at the palmar aspect of the carpus. Note a small stalk-like connection to the adjacent radiocarpal joint (arrow)
insightsimaging.springeropen.com • CC-by-2.0
MRI
characteristics of cysts and “cyst-like” lesions in and around the knee: what the radiologist needs to know. ACL ganglion cysts. Two sequential sagittal fat saturated proton density weighted images in two different patients (upper and lower row) demonstrating a cystic lesion (black arrow) at the upper segment of the ACL with part of the lesion (white arrow) dispersing into the ACL fibres
insightsimaging.springeropen.com • Open Access
Infant with a
papable nodule on the palm of the right hand between the fourth and fifth digits. Transverse US of the palm of the right hand (above) shows at the top of the image a round, unilocular, anechoic lesion between the fourth and fifth digits. Sagittal US of the palm of the right hand between the fourth and fifth digits (below) shows that the round anechoic lesion has posterior acoustic enhancement.The diagnosis was ganglion cyst.
pediatricimaging.org • CC-by-nc-sa 4.0
Radiopaedia • CC-by-nc-sa 3.0 • de

Ganglion cysts are non-malignant cystic masses that occur in association with musculoskeletal structures. They are the most common soft tissue mass in the hand and wrist.

Terminology

Ganglion cysts are sometimes also simply referred to as ganglia or a ganglion, but should not be confused with the anatomical term ganglion.

Epidemiology

They occur more commonly in young women (especially in and around the hand) .

Clinical presentation

They can cause a myriad of symptoms dependent on location due to mass effect on adjacent structures, and these are best discussed under location specific subsites. A proportion of patients have a history of trauma.

Pathology

The etiology of ganglion cysts is unclear and are generally thought to result from myxoid degeneration of the connective tissue associated with joint capsules and tendon sheaths . They may represent sequelae of synovial herniations or coalescence of small degenerative cysts arising from the tendon sheath, joint capsule or bursae. Typically, they are attached to the underlying joint capsule or tendon sheath .

Some ganglion cysts can occur in post-traumatic and post surgical situations .

Histology

Histologically, ganglia have a thin connective tissue capsule, but no true synovial lining, and contain mucinous material filled with gelatinous fluid rich in hyaluronic acid and other mucopolysaccharides .

Location

They can occur within

According to anatomy

They can occur in numerous locations but most commonly (70-80% of cases) occur in relation to the hand or wrist (ganglion cysts of the hand and wrist) in this location, notable specific subsites include :

  • dorsum of the wrist: ~60% of all hand ganglion cysts
  • volar aspect of the wrist: ~20%
  • flexor tendon sheath: ~10%
  • in association with the distal interphalangeal joint: ~10%

Other notable locations include:

Classification

There are many ways of classifying ganglion cysts.

In relation to structure, e.g. bone
In relation to structure, e.g. joint
In relation to structure, e.g. nerve

Radiographic features

Ultrasound

The vast majority are anechoic to hypoechoic on ultrasound and have well-defined margins . Many demonstrate internal septations as well as acoustic enhancement .

MRI

Usually seen as a unilocular or multilocular rounded or lobular fluid signal mass, adjacent to a joint or tendon sheath. Very small cysts may simulate a small effusion, but a clue to the diagnosis is the paucity of fluid in the remainder of the joint and the focal nature of the fluid. Periosteal bone formation may be visible.

Signal characteristics include:

  • T1: typically ganglia are low signal although high proteinaceous content or hemorrhage may result in lesions appearing isointense or hyperintense on T1 weighted images
  • T2/STIR: typically high signal
Ruptured cysts

Ruptured cysts are often irregularly delineated and show pericapsular edema on T2 weighted image . The cyst itself may show diffuse enhancement after intravenous administration of gadolinium contrast, but there is often an absence of enhancement of the pericapsular soft tissue edema.

History and etymology

Ganglion cysts are thought to be first described by Hippocrates as ‘‘knots of tissue containing mucoid flesh’’.

Differential diagnosis

General imaging differential considerations include:

  • synovial cyst: these have a synovial lining, and although histologically distinct from ganglia, are indistinguishable on imaging
Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu Ganglion (Überbein):
Synovialzyste
 
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pseudotumoröse
Weichteilläsionen von Hand und Handgelenk
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