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Ruptured Peroneal Ganglion Cyst: MRI with Surgical Correlation
Abstract:
We describe a case of a proximal anterior leg mass causing weak great toe dorsiflexion. The lesion was demonstrated on MR imaging as a multilocular cystic lesion within the extensor digitorum longus muscle that was connected to the proximal tibio-fibular joint by a pedicle. Fluid extravasation was present that extended inferiorly from the lesion along the fascial planes into the distal anterior lower leg. At surgery, the lesion was found to be compressing the deep peroneal nerve. The final pathologic diagnosis was peroneal ganglion cyst.
Insights
A peroneal ganglion cyst caused a leg mass and weak great toe dorsiflexion by compressing the deep peroneal nerve. This cystic lesion, connected to the tibiofibular joint, was identified via MRI and confirmed surgically.
Area of Science:
- Orthopedic Surgery
- Neurology
- Radiology
Background:
- A proximal anterior leg mass presented with symptoms of weak great toe dorsiflexion.
- Magnetic resonance (MR) imaging is a key diagnostic tool for soft tissue lesions in the lower extremity.
Observation:
- MR imaging revealed a multilocular cystic lesion within the extensor digitorum longus muscle.
- The lesion was noted to have a pedicular connection to the proximal tibiofibular joint.
- Fluid extravasation was observed extending inferiorly along fascial planes.
Findings:
- Surgical exploration confirmed the lesion was compressing the deep peroneal nerve.
- The final pathologic diagnosis was a peroneal ganglion cyst.
Implications:
- This case highlights the importance of considering peroneal ganglion cysts in the differential diagnosis of anterior leg masses causing nerve compression.
- Accurate diagnosis through advanced imaging like MRI is crucial for appropriate surgical planning and management.
- Understanding the anatomical relationship between the cyst, nerve, and joint is vital for successful treatment outcomes.
