Hemorrhagic Synovial Cyst Associated with Rheumatoid Atlantoaxial Subluxation

Sheen, Jae Jon; Seo, Dong Kwang; Rhim, Seung Chul; Choi, Seung Ho

doi:10.14245/kjs.2013.10.2.85

Cited by 7 publications

(6 citation statements)

References 8 publications

(12 reference statements)

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“…Giant Rheumatoid-associated synovial cysts in the foot have only been reported once [6] in the literature according to our PubMed search. Giant synovial cysts are most common in the knee but only rarely reported with RA pressurebearing joints: the hip [7], the shoulder [8], and in areas of dislocation (atlantoaxial subluxation) [9]. Although synovial tissue edema and proliferation is normal in RA, the development of such a giant synovial mass in the foot is rare in our experience and review.…”

Section: Discussionmentioning

confidence: 88%

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2018

OROAJ

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Section: Discussionmentioning

confidence: 88%

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2018

OROAJ

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“…Some causes of ROP involve cyst formation, which can potentially grow to exceptionally large sizes extending from clivus to the caudad C2–C4 levels [ Table 1 ]. [ 1 - 3 ] ROP cysts are likely attributed to atlantoaxial degenerative articular cyst formation and may reflect;[ 1 ] micro-bleeding,[ 5 ] loculated collections of mucinous fluid from synovium,[ 4 ] and relatively higher amounts of hyaline cartilage. [ 6 ] Here, the composition of the ventral layer of ROP was attributed to a thickened transverse ligament with fibrocartilage metaplasia, while the dorsal layer was due to a cystic component (i.e., the septum of the posterior longitudinal ligament/tectorial membrane).…”

Section: Discussionmentioning

confidence: 99%

Retro-odontoid pseudotumor presenting double layer on MRI: A case report

Kanematsu¹,

Hanakita²,

Takahashi³

et al. 2022

Surgical Neurology International

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Background: Retro-odontoid pseudotumors (ROPs) typically present as a single mass posterior to the odontoid ranging from isointense to hypointense relative on T1-weighted magnetic resonance (MR) imaging (MRI T1WI). Here, a patient with ROP exhibited the double-layer sign on the MRI T1WI characterized by an initial ventral layer posterior to the odontoid process followed by a secondary dorsal layer. Case Description: An 84-year-old male presented with cervical myelopathy attributed to ROP resulting in atlantoaxial instability on dynamic X-ray studies, and the double-layer sign on the T1 MR accompanied by a cystic component. MR following C1–C2 posterior fusion, the patient’s myelopathy resolved and both layers spontaneously regressed on the follow-up MR studies. Conclusion: The MR-documented double layer sign with ROP, likely attributable to reactive hypertrophy of the transverse ligament with cystic components, may demonstrate spontaneous MR regression with symptom resolution following a C1–C2 posterior fusion.

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“…Although some laboratory indexes such as ESR and CRP are very important for the evaluation of inflammatory, imaging examination can estimate the changes in synovium, cartilage, and bone as a result of the disease activity or in response to the therapy. [ 12 – 14 ] X-ray and CT are more advantageous than MRI for detecting the bone damage such as osteoporosis and bone erosions, while MR will be more sensitive and specific in demonstrating inflammation of joints, bursa, tendon sheath, and bone marrow. [ 15 – 17 ] In general, the synovitis is defined as a thickness area with intermediate to low signal on T1-weighted images, but high signal on T2-weighted images.…”

Section: Discussionmentioning

confidence: 99%

Multiple extra-articular synovial cysts accompanied by rheumatoid arthritis in the bilateral elbow joints

Zhang

Wang²,

Mao³

et al. 2018

Medicine

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Rationale:Synovial cysts are well known in rheumatoid arthritis (RA), and most common in the popliteal fossa. They may produce lots of local symptoms and complaints, which may present initially as an unrelated clinical condition. Few studies have reported multiple extra-articular synovial cysts (MESCs) in the RA patients. Early diagnosis is crucial for patient treatment.Patient concerns:A 50-year-old man without any special clinical histories found a soya bean size bump at the left elbow medially, then multiple lumps were found at bilateral elbows and gradually increasing. No pain, no activity, no redness, and swelling. Magnetic resonance imaging (MRI) showed multiple cystic lesions in the bursa and surrounding soft tissue of bilateral elbow joints. In addition, the elbow joint bursa was swollen and the synovial membrane was significantly thickened.Diagnoses:The man was diagnosed as RA with multiple extra-articular synovial cysts formation.Interventions:The patient was performed tylectomy of the right elbow. Other lumps were punctured and injected with compound betamethasone injection.Outcomes:The bumps were reduced in size and the swelling relieved, and the patient was sent to the department of rheumatology and immunology for further treatment.Lessons:In this case, it is difficult for the diagnosis of RA because of no relative histories and simultaneously multiple cystic lesions in multiple joints. Imaging examinations can show the characteristics of such kind of disease and be very helpful for the diagnosis and differentiate diagnosis.

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Hemorrhagic Synovial Cyst Associated with Rheumatoid Atlantoaxial Subluxation

Cited by 7 publications

References 8 publications

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Retro-odontoid pseudotumor presenting double layer on MRI: A case report

Multiple extra-articular synovial cysts accompanied by rheumatoid arthritis in the bilateral elbow joints

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