Spectrum of MRI features of ganglion and synovial cysts

Abstract

Ganglion and synovial cysts occur mainly, but not necessarily, in association with osteoarthritis. Presentation varies widely, ranging from small, incidentally detected, asymptomatic lesions to giant ones that might be the source of symptoms, either due to their compressive effect on adjacent structures or due to complications, such as rupture. On magnetic resonance imaging they are typically presented as smooth, well-circumscribed, thin-walled, unilocular, and homogeneously T2-hyperintense lesions. An identifiable thin stalk communicating to the joint space is not infrequent. Nevertheless, depending on their age, anatomic location, and eventual complication, they might have many distinct appearances, including septae and internal debris, which the radiologist must be familiar with in order to accurately differentiate them from worrisome cystic-like lesions. With regard to this diversity, some illustrative cases are presented.

Asymptomatic Posterior Synovial Cyst of the Hip: A Case Report

“…SC and GC are frequent benign cystic lesions occurring in various bodily joints. They are usually associated with degenerative joint disease, rheumatoid arthritis, trauma and tumors [3,4]. Angelini A, et al have analyzed previous reported cases of anterior SC and GC of the hip and showed that out of 39 reported cases, 44 % had no comorbidities while 31% had rheumatoid arthritis, 23% had osteoarthritis and 2% had hip contractures [3].…”

“…Indeed, the knee is the most common joint followed by the hip where SC is more common than GC. GC occurs primarily in the wrist arising most commonly from the dorsal aspect of the scapholunate ligament followed by the radioscaphoidscapholunated interval, the scaphotrapezial, or the metacarpotrapezial joints [4]. Paralabral cysts (PC) are common cystic lesions in the hip joint and are associated with an intraarticular hip pathology, in particular labral tears [5].…”

Lesions involving the outer surface of the bone in children: a pictorial review

“…Lack of a true endothelial lining constitutes the differentiating feature from synovial cysts [18]. Ganglion cysts can arise from the joint capsule, ligaments, tendon sheaths, bursae or subchondral bone [19]. …”

“…Usually, no solid/enhancing components are seen; although, occasionally, internal T2 hypointense debris or even osseous loose bodies can be seen [19]. Erosion/invasion of adjacent bone may be present.…”

“…Adjacent oedema and fluid tracking can be seen with cyst rupture [19].

Post-traumatic

Chronic avulsive injuries/cortical desmoid:

Cortical desmoids are usually a consequence of an avulsive injury or stress reaction at the insertion site of the medial head of the gastrocnemius muscle or adductor magnus.

On plain films, these appear as small radiololucent saucer-shaped lesions or areas of cortical irregularity with an associated sclerotic base, typically at the posteromedial aspect of the distal femoral condyle (Fig.

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