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Intraosseous ganglion

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

Demographics and clinical presentation

Tends to occur in middle age. Patients may have mild localized pain.

Pathology

They are uni- / multilocular cyst surrounded by 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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