Juxtaacetabular ganglionic (or synovial) cysts: CT and MR features

Area of Science:

• Radiology
• Orthopedic Surgery
• Medical Imaging

Background:

• Hip pain can stem from various pathologies, including less commonly recognized cystic lesions.
• Soft tissue masses adjacent to the acetabulum may present with or without intra-lesional gas.
• Acetabular labral tears can be associated with peri-acetabular cystic formations.

Purpose of the Study:

• To describe the radiographic, computed tomography (CT), and magnetic resonance imaging (MRI) findings of soft tissue cystic lesions adjacent to the acetabulum.
• To evaluate the clinical significance and diagnostic utility of advanced imaging in identifying these hip pathologies.
• To highlight the role of synovial or ganglionic cysts as a potential cause of hip symptomatology.

Main Methods:

• Retrospective review of imaging examinations (radiography, CT, MRI) in seven patients with peri-acetabular cystic lesions.
• Correlation of imaging findings with clinical manifestations and arthrographic confirmation of labral tears in select cases.
• Detailed analysis of cyst characteristics, including relationship to acetabular bone, labrum, and hip joint.

Main Results:

• Radiographic evidence included supraacetabular bone erosions, acetabular cysts, soft tissue masses (sometimes with gas), joint space narrowing, and abnormal hip configuration.
• Two patients demonstrated associated acetabular labral tears confirmed by arthrography.
• CT and MRI provided superior visualization of soft tissue ganglia and their anatomical relationships.

Conclusions:

• Soft tissue cystic lesions, such as synovial or ganglionic cysts, are an important and frequently overlooked cause of hip pain.
• Advanced imaging techniques like CT and MRI are crucial for accurate delineation and characterization of these peri-acetabular cysts.
• Recognition of these cystic lesions is vital for appropriate diagnosis and management of hip symptomatology.