Intraosseous ganglion

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


Tends to occur in middle age.

Clinical presentation

Patients may have mild localised pain.


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

  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)

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. 

  • solitary, unilocular or multilocular 2
  • usually sclerotic rim is present
Bone scan

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

Differential diagnosis

  • post-traumatic/degenerative cyst

See also

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