An unusual presentation of intoeing in a child

Area of Science:

• Orthopedics
• Pediatric Neurology
• Radiology

Background:

• Ganglion cysts are benign cystic masses originating from joint capsules or tendon sheaths.
• Nerve compression by ganglion cysts is more common in adults, typically affecting the peroneal nerve.
• Pediatric cases of peripheral nerve compression by ganglion cysts are exceptionally rare.

Observation:

• A 3-year-old child presented with intoeing, a gait abnormality.
• Physical examination revealed a palpable mass in the proximal right leg.
• Diagnostic workup identified a ganglion cyst as the cause of the mass.

Findings:

• The ganglion cyst was compressing the common peroneal nerve.
• This represents a rare instance of symptomatic peroneal nerve palsy in a pediatric patient due to a ganglion cyst.
• Literature review confirmed the scarcity of similar pediatric cases.

Implications:

• This case underscores the importance of considering rare etiologies for pediatric limb abnormalities.
• Prompt diagnosis and management of soft tissue masses are crucial in children.
• Imaging modalities play a vital role in evaluating soft tissue masses and nerve impingement.