Intraneural ganglion cyst

Case contributed by Jeremy Jones
Diagnosis almost certain

Presentation

Right sided neural pain around the knee following a football injury months previously. Symptoms worsening despite rest. No fracture.

Patient Data

Age: 10 years
Gender: Male
mri

High-T2w, intermediate-PD lobulated lesion extends from the posterior surface of the proximal tibiofibular joint at the knee, proximally along the articular branch and the tibial nerve.

Case Discussion

Features here are of an intraneural ganglion cyst.

A capsular tear at the proximal tibiofibular joint results in fluid tracking in the epineural sheath of the articular branch and then along the path of least resistance, the tibial nerve. The fluid may track all the way up to the sciatic bifurcation and even descend retrograde along the femoral nerve.

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