intraosseous ganglion

Intraosseous
ganglion of the distal tibia in a 37-year-old woman. Plain radiograph shows an osteolytic lesion with marginal osteosclerosis. Three years after the operation of curettage and bone grafting, osteosclerosis is seen.
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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)
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Spectrum of
MRI features of ganglion and synovial cysts. Intraosseous ganglion cyst of the tibia incidentally depicted in a 40-year-old man who underwent an MRI scan due to intermittent, subacute non-specific knee pain. Sagittal FS PD-WI shows a metaepiphyseal, large, multiloculated cystic lesion of the tibia, which communicates with the articular surface through a thin stalk (arrow) extending into the interspinous region, close to the anterior cruciate ligament tibial insertion. Tb, tibia; ACL, anterior cruciate ligament
insightsimaging.springeropen.com • Open Access
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An intraosseous ganglion (plural: ganglia) is a benign subchondral radiolucent lesion without degenerative arthritis.

Epidemiology 

Tends to occur in middle age.

Clinical presentation

Patients may have mild localized pain.

Pathology

They are uni-/multilocular cysts surrounded by a fibrous lining, containing gelatinous material.

Origin
  • mucoid degeneration of intraosseous connective tissue perhaps due to trauma/ischemia
  • penetration of juxtaosseous soft-tissue ganglion (=synovial herniation) into underlying bone (occasionally)
    • Location

    Common locations are:

    • epiphyses of long bones (medial malleolus, femoral head, proximal tibia, carpal bones) 
    • subarticular flat bone (acetabulum)

    Radiographic features

    Plain radiograph

    Typically well-demarcated solitary lytic lesion, with a sclerotic margin. No communication with joint can be demonstrated.

    MRI
    • solitary, unilocular or multilocular
    • usually sclerotic rim is present
    Bone scan

    Bone scans demonstrate increased radiotracer uptake (in 10%).

    Differential diagnosis

    See also

    Siehe auch:
    und weiter:
    Assoziationen und Differentialdiagnosen zu intraossäres Ganglion:
    nicht
    ossifizierendes Fibrom
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    Enchondrom
     
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    intraossäre
    Zyste mit Lufteinschluss
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    subchondrale
    Zysten
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