Ganglion cyst versus synovial cyst? Ultrasound characteristics through a review of the literature

Abstract

Ultrasonographic characteristics of two common musculoskeletal lesions, ganglion cysts (GCs) and synovial cysts (SCs) are presented through a review of the literature. Although similar in many ways, these two lesions display different morphostructural characteristics justifying, in our view, their descriptions as separate entities. Mainly different from an anatomopathologic point of view, they also differ in their potential therapeutic implications. A symptomatic GC, refractory to conservative therapy, may require surgical excision of the cyst itself. For SC, therapy should primarily be oriented toward identifying and correcting the often coexisting intra-articular disease instead of only targeting merely its consequence, the SC.

Role of FNAC in diagnosing lesions of hand and wrist

“…Synovial cyst is mostly associated with joint derangement due to effusion. Its treatment involves correcting the intra‐articular disease rather than aspiration of the cyst alone . The diagnosis of epidermal cyst is usually straightforward.…”

Sonographic Characteristics of Apocrine Nodular Hidradenoma of the Skin

“…Angiomatous tumors are mostly hypoechoic hypervascular solid lesions without septa or cystic areas. Ganglion cysts usually appear as anechoic, avascular and sometimes lobulated cystic structures commonly attached or close to tendons, ligaments, or joints …”

Ultrasound of the Gruberi Bursa With Cadaveric and MRI Correlation

“…Therefore, most, if not all, fluid collections in the region of the Gruberi bursa exhibited the ultrasound features of bursae (i.e., unilocular and compressible) as opposed to the ultrasound features of ganglion cysts or other collections. Among the few fluid collections centered in the sinus tarsi (i.e., not in the typical location of the Gruberi bursa), 89% were multilocular and therefore were more characteristic of ganglion cysts [14]. Only four cases were identified with fluid at sites other than the dorsolateral talus or sinus tarsi.…”

“…When collapsed, bursae might not be visible on ultrasound [13]; a bursa distended with fluid typically appears to be anechoic, unilocular, and compressible on ultrasound [14]. Some bursae are asymptomatic, whereas others can cause pain, swelling, nerve compression, and even osseous erosion [12].…”

“…In contrast to bursae, ganglion cysts are typically noncompressible on ultrasound, are multilocular, and contain viscous fluid [16]; the lack of compressibility of ganglion cysts on ultrasound is thought to be at least in part because of their thick capsule [16]. A recent review article showed that anatomic location and compressibility were the most helpful findings in discriminating between a bursa and a ganglion cyst on ultrasound [14].…”