Intraneural Ganglion in Superficial Radial Nerve Mimics de Quervain Tenosynovitis

Abstract

There is only one case report of intraneural ganglion in the superficial radial nerve. In that case, the patient had symptoms consistent with nerve irritation, including radiating pain and paresthesias. In contrast to that previous report, the patient in the current case had only localized pain, no paresthesias, and a physical exam consistent with de Quervain tenosynovitis. Clinical Relevance This case demonstrates that an intraneural ganglion cyst can mimic the symptoms of de Quervain tenosynovitis without the more usual presentation of painful paresthesias.

Cystic lesions of peripheral nerves: Are we missing the diagnosis of the intraneural ganglion cyst?

“…These lesions commonly affect the peroneal nerve at the knee but can involve the other peripheral nerves[7,26,27] as shown in this series. They usually present with mild symptoms and remain undiagnosed initially[27].…”

“…INGC is often referred to as a rare non-neoplastic mucinous cyst located within the epineurium of peripheral nerves and is closely related to an adjoining joint[ 7 - 11 , 20 , 24 , 25 ]. These lesions commonly affect the peroneal nerve at the knee but can involve the other peripheral nerves[ 7 , 26 , 27 ] as shown in this series. They usually present with mild symptoms and remain undiagnosed initially[ 27 ].…”

“…These lesions commonly affect the peroneal nerve at the knee but can involve the other peripheral nerves[ 7 , 26 , 27 ] as shown in this series. They usually present with mild symptoms and remain undiagnosed initially[ 27 ]. MRI plays an important role in diagnosing this condition and can reliably demonstrate the presence and the pattern of the cystic lesion and the exact level of communication of the cyst to the adjacent joint[ 8 , 20 , 28 , 29 ].…”