Intraneural ganglion cysts of the lower limb

Intraneural ganglion cysts are rare. They affect the peripheral nerves. According to the most widely accepted theory (articular/synovial theory), the cysts are formed from a capsular defect of an adjacent joint, so that synovial fluid spreads along the epineurium of a nerve branch. This leads to diverse neurological symptoms. We will illustrate this disease based on three of our own cases.

Patients were examined between 2011 and 2018 using lower limb MRI. MRI scans were also performed for the follow-up examinations.

The patients had many symptoms. We were able to accurately detect the intraneural ganglion cysts on MRI and provide the treating surgeons with the basis for the operation to be performed. The success of surgical therapy depends on the resection of the nerve endings supplying the joint as the only way to treat the origin of the disease and prevent recurrence. Based on our case studies, we can support the commonly favored articular/synovial theory.

· Intraneural ganglion cysts can cause diverse neurological symptoms depending on their location.. · The pathogenesis is reasonably explained by the articular/synovial theory, which states that cysts are the result of a capsular defect of a joint.. · MRI is the method of choice for diagnosing intraneural ganglion cysts. However, ultrasound is also important.. · Surgery is the only curative treatment with treatment success being dependent on ligature of the nerve endings supplying the articular branch..

· Fricke T, Schmitt AD, Jansen O. Intraneural ganglion cysts of the lower limb. Fortschr Röntgenstr 2019; 191: 732 - 738.