Ultrasound-guided aspiration of symptomatic intraneural ganglion cyst within the tibial nerve

Excerpt

Intraneural ganglia are rare non-neoplastic cysts caused by the accumulation of thick mucinous (mucoid) fluid within the epineurium of peripheral nerves, encased in a dense fibrous capsule [1, 2]. These cysts cause compression of adjacent nerve fascicles, resulting in leg paresthesias, pain, weakness, muscle denervation, and atrophy [3]. The peroneal (fibular) nerve at the level of the fibular neck is most commonly affected [4‐6]. Involvement of other peripheral nerves surrounding articular surfaces (including the radial, ulnar, median, sciatic, tibial and posterior interosseous nerves) has been previously described [6‐21]. Tibial intraneural ganglia in the knee region are particularly rare, with fewer than 15 reported cases in the literature [2, 8‐15]. Although their ultrasound (US) and magnetic resonance imaging (MRI) appearance has been previously documented [8‐15, 22], to our knowledge no one has reported the ultrasound-guided aspiration of a symptomatic intraneural ganglion cyst within the tibial nerve. …