Patel Purvak, Schucany William G
Department of Radiology, Baylor University Medical Center at Dallas.
Proc (Bayl Univ Med Cent). 2012 Apr;25(2):132-5. doi: 10.1080/08998280.2012.11928809.
Cystic lesions around the knee are a relatively common occurrence. Several types of cysts have been reported, including synovial, bursal, and ganglion. Ganglion cysts are not lined by synovial cells. Their location is highly variable, with occurrences described in the fat pads near the tibia or femur, muscles, nerves, and arteries. Intraneural ganglia are rare nonneoplastic cysts caused by the accumulation of thick mucinous fluid within the epineurium of peripheral nerves, encased in a dense fibrous capsule. These cysts can cause compression of the adjacent nerve fascicles, resulting in pain, paresthesias, weakness, muscle denervation, and atrophy. They are most commonly manifested by local and radiating pain, but sensory and motor deficits have also been described. Involvement of the tibial nerve is exceptionally rare, with <15 reported cases in the literature. We present a case of intraneural tibial ganglion cyst in a young woman. We also discuss the imaging features, differential considerations, proposed pathogenesis and anatomic origin, and treatment of this rare entity.
膝关节周围的囊性病变较为常见。已报道的囊肿类型有几种，包括滑膜囊肿、滑液囊肿和腱鞘囊肿。腱鞘囊肿没有滑膜细胞衬里。其位置变化很大，在胫骨或股骨附近的脂肪垫、肌肉、神经和动脉中均有发生。神经内腱鞘囊肿是一种罕见的非肿瘤性囊肿，由外周神经的神经外膜内浓稠黏液性液体聚集形成，被致密的纤维包膜包裹。这些囊肿可导致相邻神经束受压，引起疼痛、感觉异常、无力、肌肉失神经支配和萎缩。它们最常见的表现是局部疼痛和放射性疼痛，但也有感觉和运动功能障碍的报道。胫神经受累极为罕见，文献报道病例少于15例。我们报告一例年轻女性的胫神经内腱鞘囊肿病例。我们还将讨论这种罕见疾病的影像学特征、鉴别诊断、推测的发病机制和解剖学起源以及治疗方法。
