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Diseases of the Peripheral Nerve and Mononeuropathies
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Diana Mnatsakanova, Charles K. Abrams
Deformities of the elbow joint: Tardy ulnar palsy: deformities of the elbow due to previous fractures of the humerus or other trauma to the joint.Compression by the arcade of Struthers.Arthritis.Ganglion cyst.Rheumatoid synovial cyst.
Imaging of the spine
Published in Sarah McWilliams, Practical Radiological Anatomy, 2011
Fig. 5.57e,f shows axial T2-weighted images through the spine. At the L4 level the theca appears normal. However, at the L5 level there is narrowing of the canal dimensions due to a combination of ligamentous and facet joint hypertrophy and a generalized disc bulge. In addition, a small well-circumscribed lesion is seen related to the left facet joint. This is a synovial cyst. The normal root and theca cannot be seen at this level. The loss of visualization of the nerve root is an indication of it being compromised.
Arteropathies, Microcirculation and Vasculitis
Published in Mary N. Sheppard, Practical Cardiovascular Pathology, 2022
Adventitial cystic disease is a very rare condition characterized by the accumulation of a cyst-like space filled with gelatinous substance in the adventitia of the popliteal artery. The cyst usually compresses the vessel lumen, causing claudication. Several cases of venous adventitial cystic disease, particularly in the common femoral or external iliac vein, have been reported. The heterogeneity of terminology applied to this entity (synovial cyst, ganglion cyst and adventitial cyst) has led to considerable confusion. A cyst is a closed sac with a distinct cellular lining. A pseudocyst is a cyst-like structure that lacks epithelial or endothelial cell linings. A synovial cyst is a juxta-articular fluid-filled collection lined by synovial cells and may communicate with the joint via a stalk. Ganglion cyst is caused by a defect in the joint capsule or tendon sheath which allows the joint fluid to leak from the joint space and become surrounded by fibrous connective tissues and is thus a pseudocyst. Adventitial cystic disease is a variant of ganglionic cyst in which the cyst extends along the vessel wall adventitia. Due to the strong fibroelastic nature of the adventitia, the cyst extends proximally or distally along the vessel until it grows large enough to compress the lumen in a concentric or eccentric manner. Because the cyst extends in the confined area of the adventitia, it can easily compress the vessel lumen even when it is small. The extension can be cranial, caudal, transverse or spiral along the vessel axis, which makes complete cyst excision extremely difficult. Because the cyst and the vessel share the adventitia, it is immensely challenging to remove the cyst completely without causing vessel tear and aneurysmal dilation of the vessel wall. Venous adventitial cyst also occurs and complete removal of the cyst wall compressing the vein is extremely difficult and commonly results in vein tearing or venous aneurysmal change after cyst resection. This usually leads to vessel replacement with a patch or an interposition graft. The joint connection should be eliminated to prevent recurrence.8
Mid thoracic intra-spinal facet cyst with lumbar canal stenosis: a rare ‘double crush’
Published in International Journal of Neuroscience, 2023
Abhinandan Reddy Mallepally, Nandan Marathe, Jeevan Kumar Sharma, Bibhudendu Mohaptra, Kalidutta Das
MR imaging is the investigation of choice. FC generally seen as a well-demarcated epidural mass with iso-intense or hyper-intense signal on T1- and T2-weighted images. The slight hyper-intensity seen could be due to paramagnetic character of the hemorrhagic breakdown products from the cyst fluid [15,16]. Some longstanding FC may appear hypo-intense on both T1- and T2-weighted images because of calcification. Rarely, MRI shows signal void caused by vacuum phenomenon. Adding Gadolinium Contrast helps to differentiate other pathologies (tumor or abscess) [17]. Tillich et al. described presence of communication between synovial cyst and facet joint during surgery that is rarely appreciated on MRI, due to its small size. [15]. This communication may help us understand the dynamic size changes nature of these cysts due to ‘to and fro’ movement of fluid under mechanical load [18].
Isolated proximal tibiofibular joint arthritis in a patient with juvenile idiopathic arthritis: A case report
Published in Modern Rheumatology, 2018
Hiroki Wakabayashi, Tomoki Nakamura, Akinobu Nishimura, Tomohito Hagi, Masahiro Hasegawa, Akihiro Sudo
A 14-year-old girl presented to her orthopedist with 6 months history of lateral right knee pain. There was no history of trauma and no family history of rheumatic diseases. Examination showed only tenderness over the right fibular head. The complete blood count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) concentration were normal. Although her plain radiographs were normal, non-contrast-enhanced magnetic resonance imaging (MRI) showed a moderate PTF joint effusion with bony edema and surrounding synovial enhancement with synovial thickening. The T1-weighted image showed a relatively low-iso intense signal, and the T2-weighted image showed a relatively hyper-intense signal compared to skeletal muscle (Figure 1A–D). On MRI, a bone soft tissue tumor, especially pigmented villonodular synovitis (PVS), was suspected. A provisional diagnosis of a synovial cyst or PVS was made, and it was decided to do a biopsy. However, the patient refused the biopsy because her knee pain improved with NSAID treatment. Follow-up MRI performed 3 months later showed no remarkable changes. Therefore, the patient was followed as an outpatient with orthopedic evaluation, including plain radiographs and/or MRI, every year.
Facet joint cyst haematoma: a rare cause of cauda equina syndrome
Published in British Journal of Neurosurgery, 2023
Ashwin Kumaria, Alexandra Wood, Harinder P. S. Gakhar, Simon P. S. Howarth, Antony H. Bateman
Facet joint cysts are a type of synovial cyst associated with spinal degenerative changes, especially spondylolisthesis and facet joint arthropathy.1 Facet joint cysts are an uncommon cause of radiculopathic leg and back pain.2 Haemorrhage of a facet joint cyst, typically in the context of trauma or antiplatelet/anticoagulant medication is a highly uncommon cause of pain and neurological deficit.3,4