Rodriguez Miralles J, Natera Cisneros L, Escolà A, Fallone J C, Cots M, Espiga X
Hospital General de Catalunya, Street Pedro i Pons 1, 08190 Sant Cugat del Vallés, Barcelona, Spain; Consorci Hospitalari de Vic, Street Francesc Pla 'El Vigatà' 1, 08500 Vic, Barcelona, Spain.
Hospital General de Catalunya, Street Pedro i Pons 1, 08190 Sant Cugat del Vallés, Barcelona, Spain; Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, street Sant Quintí 89, 08026 Barcelona, Spain.
Orthop Traumatol Surg Res. 2016 Oct;102(6):791-4. doi: 10.1016/j.otsr.2016.05.014. Epub 2016 Aug 23.
Two types of ganglion cysts at the elbow have been described depending on their anatomic location. Type A ganglion cyst is located proximal to the arcade of Frohse, and type B distal to it. Compressive neuropathies of the radial nerve at the level of the radial tunnel may lead to two different clinical entities with different clinical manifestations. These different conditions depend on which branch is involved. Although compression of the deep motor branch due to a ganglion cyst has been previously described, affection of the superficial sensory branch is considered much rarer. The aim of this study was to describe a series of patients in which painful and dysesthetic symptoms arose from superficial radial nerve compression due to type A ganglion cysts coming from the radiocapitellar joint.
A review of currently available literature about the disease was carried out. The clinical, histological and radiological records of a series of eight cases (seven patients) with compression of the superficial radial nerve diagnosed and treated between 2008 and 2011 were retrospectively reviewed. All patients complained of pain and dysesthesia at the lateral aspect of the elbow. All patients were initially diagnosed and managed as lateral epicondylitis. Persistence of the symptoms was evidenced in all patients after a course of six months of non-operative management. Magnetic resonance imaging was performed and revealed the presence of a mass compatible with a ganglion cyst coming from the radiocapitellar joint, pushing up the superficial sensory branch of the radial nerve and compressing it against the extensor carpi radialis brevis. Surgical excision was performed in all cases.
Histology confirmed the diagnosis of ganglion cysts. Histological findings consisted of dense fibrous tissue, with no synovial or epithelial lining and mucoid material with foamy macrophages. The mean follow-up after surgical excision was 28months (range 24-30). The symptoms subsided in all cases. No complications were registered during the follow-up.
Type A ganglion cysts of the radiocapitellar joint may involve compression of the superficial radial nerve. Our series of eight cases may suggest that this pathology might not be as rare as it was thought before. This evidence may be useful for the orthopaedic population, who may have another differential diagnosis when managing cases of painful symptoms located in the lateral aspect of the elbow.
Therapeutic study.
IV.
根据解剖位置，肘部的腱鞘囊肿可分为两种类型。A 型腱鞘囊肿位于弗罗瑟弓近端，B 型位于其远端。桡神经在桡管水平受压可导致两种不同的临床实体，临床表现各异。这些不同情况取决于受累的分支。虽然先前已有腱鞘囊肿压迫桡神经深运动支的描述，但桡神经浅感觉支受影响则被认为更为罕见。本研究的目的是描述一系列因来自桡骨小头关节的 A 型腱鞘囊肿导致桡神经浅支受压而出现疼痛和感觉异常症状的患者。
对目前关于该疾病的可用文献进行了综述。回顾性分析了 2008 年至 2011 年间诊断并治疗的 8 例（7 名患者）桡神经浅支受压患者的临床、组织学和放射学记录。所有患者均主诉肘部外侧疼痛和感觉异常。所有患者最初均被诊断为外侧肱骨髁炎并接受相应治疗。经过 6 个月的非手术治疗，所有患者症状持续存在。进行了磁共振成像检查，结果显示存在一个与来自桡骨小头关节的腱鞘囊肿相符的肿块，该肿块将桡神经浅感觉支向上推，并将其压迫在桡侧腕短伸肌上。所有病例均进行了手术切除。
组织学检查证实为腱鞘囊肿。组织学表现为致密纤维组织，无滑膜或上皮衬里，以及含有泡沫巨噬细胞的黏液样物质。手术切除后的平均随访时间为 28 个月（范围 24 - 30 个月）。所有病例症状均消退。随访期间未出现并发症。
桡骨小头关节的 A 型腱鞘囊肿可能会压迫桡神经浅支。我们的 8 例病例系列可能表明，这种病理情况可能不像之前认为的那么罕见。这一证据可能对骨科医生有用，他们在处理肘部外侧疼痛症状的病例时可能会有另一种鉴别诊断。
治疗性研究。
IV 级。
Zotero 插件