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Intraosseous ganglion

An intraosseous ganglion is a benign subchondral radiolucent lesion without degenerative arthritis. 

Epidemiology 

Tends to occur in middle age.

Clinical presentation

Patients may have mild localised pain.

Pathology

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

Origin
  1. mucoid degeneration of intraosseous connective tissue perhaps due to trauma/ischemia
  2. 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 film

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

Bone scan

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

Differential diagnosis

  • post-traumatic/degenerative cyst

See also

 

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