RESUMO
Extra- and intraneural ganglion cysts have been described in the literature. The tibial nerve ganglion is uncommon and its occurrence without intra-articular extension is atypical. The pathogenesis of cystic degeneration localized to connective and perineural tissue secondary to chronic mechanical irritation or idiopathic mucoid degeneration is hypothesized. Since the above pathology is extremely rare and the magnetic resonance imaging examination detects the defining characteristics of the intrinsic alterations of the tibial nerve, the authors illustrate such a case of tibial intaneural ganglion cyst with its magnetic resonance neurography and sonography appearances.
Assuntos
Cistos Glanglionares/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Nervo Tibial/diagnóstico por imagem , Ultrassonografia Doppler/métodos , Tratamento Conservador , Meios de Contraste , Diagnóstico Diferencial , Cistos Glanglionares/patologia , Cistos Glanglionares/terapia , Humanos , Interpretação de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Nervo Tibial/patologiaRESUMO
PURPOSE: The aim of this case series report is to assess the effectiveness of aspiration and injection of triamcinolone acetonide for treatment of wrist synovial cysts in children. METHODS: Twenty-one records of pediatric patients with synovial cyst on the wrist treated with aspiration and triamcinolone acetonide injection were selected for analysis of their outcomes. All cases were aspirated and injected at the operating room under mask induction anesthesia. Three categories were used to classify the patients' outcomes: (1) successful treatment with no recurrence, (2) successful treatment with residual sclerotic lump, and (3) recurrence of cyst. RESULTS: Fourteen females and 7 males with an average age of 7.2 years had a mean time with the cyst of 1 year. All children were asymptomatic. After aspiration, 13 (62%) of 21 patients experienced successful treatment of the synovial cyst with no recurrence after a single intervention. Five patients had a residual lump at the site of the cyst (24%), which disappeared after an average of 6 months. Three patients experienced true recurrence of the synovial cyst (14%). Average follow-up was 2.5 years. CONCLUSIONS: Aspiration and injection of triamcinolone accounted for a considerable reduction in recurrence. Aspiration and triamcinolone acetonide injection of wrist synovial cysts is an effective and safe treatment that may be considered as first-line treatment in the pediatric population if there is no resolution after 1 year of observation.