Cases reported "Bone Cysts"

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1/15. Subperiosteal ganglion cyst of the tibia. A communication with the knee demonstrated by delayed arthrography.

    We report a patient with a subperiosteal ganglion cyst of the tibia which was imaged by radiography, arthrography, CT and MRI. The images were correlated with the arthroscopic surgical and histological findings. Spiculated formation of periosteal new bone on plain radiographs led to the initial suspicion of a malignant tumour. Demonstration of the cystic nature of the tumour using cross-sectional imaging was important for the precise diagnosis. communication between the ganglion cyst and the knee was shown by a delayed arthrographic technique, and the presence of this communication was confirmed at arthroscopy and surgically.
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2/15. Intraosseous ganglion of the trapezium in communication with the flexor carpi radialis tendon sheath.

    We report a case of an intraosseous ganglion of the trapezium that communicated with the flexor carpi radialis tendon sheath. The findings support the hypothesis that intraosseous ganglia arise from penetration of bone by synovial tissue or fluid.
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3/15. Imaging demonstration of fistulous gas communication between joint and ganglion of medial malleolus.

    We report an unusual demonstration of a fistulous gas communication between the ankle joint and ganglion of the medial malleolus. The imaging findings support the mechanical hypothesis for the genesis of intraosseous ganglion cysts.
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4/15. Giant intraosseous cyst-like lesions in rheumatoid arthritis report of a case.

    The term "intraosseous synovial cyst" is used to designate both the epiphyseal cyst-like lesions seen in patients with rheumatoid arthritis (RA) and mucoid cysts, which occur in a different setting. We report the case of a patient in whom a 4-cm cyst-like lesion developed in the left tibia 18 years after onset of RA and 6 years after osmic acid synovectomy of the left knee. Positive contrast arthrography and magnetic resonance imaging visualized a communication between the lesion and the joint space. Preexisting bone and joint lesions and increased intraarticular pressure play a major role in the genesis of cyst-like lesions in RA. In our patient, the osmic acid synovectomy may have contributed to the development of the lesion. "synovial cyst" is a misnomer for these giant lesions, which are geodes rather than cysts. Despite their low incidence, these lesions deserve attention because they raise diagnostic and therapeutic problems.
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5/15. Enlarging vertebral body pneumatocysts in the cervical spine.

    An intravertebral pneumatocyst is a relatively rare condition, and its natural course and etiology are unclear. We report a case of intravertebral pneumatocysts in the C5 vertebra that gradually enlarged during a 16-month period as documented by follow-up CT. In addition, direct communication was observed between the gas in the intervertebral disk and another pneumatocyst in the C6 vertebral body, which suggests that the gas in the pneumatocyst had an association with the gas in the degenerated intervertebral disk.
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6/15. Pretibial cyst formation after anterior cruciate ligament reconstruction with a hamstring tendon autograft.

    We report a case of pretibial cyst formation, which is a rare complication, after anterior cruciate ligament (ACL) reconstruction. The patient had undergone ACL reconstruction at age 18 and complained of pain and swelling localized on the anteromedial aspect of the ipsilateral proximal tibia 2 years postoperatively. magnetic resonance imaging showed a multilocular fluid-filled cyst arising from the outlet of the tibial bone tunnel. Open resection of the cyst was performed and communication between the tibial tunnel and the joint space was confirmed arthroscopically. The cavity of the tibial tunnel was packed with cancellous bone to seal off a water channel. The laboratory examination revealed slightly concentrated chondroitin sulfate in the cyst fluid compared with the articular fluid, despite histologic observation of no glycosaminoglycan synthesis in the cells of the cyst wall. These findings indicated that leakage of the articular fluid via the tibial tunnel might have caused the pretibial cyst after ACL reconstruction.
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7/15. arachnoid granulation cerebrospinal fluid otorrhea.

    A case report and review of the temporal bone (TB) collection in the Department of otolaryngology at SUNY health science Center in Syracuse demonstrated the occurrence of arachnoid granulations (AGs) in the posterior fossa surface of the TB and their role in cerebrospinal fluid (CSF) otorrhea. A large AG responsible for CSF otorrhea in a 64-year-old man was excised with soft tissue repair of the dural defect. Sixteen of 188 TBs (8.5%) in the collection contained 24 AGs ranging in size from 0.07 to 80.65 mm3. Nine AGs (37%) were small (less than 1 mm3) and did not demonstrate enlargement. Twelve (50%) were of intermediate size (2.50 to 9.32 mm3), and three (13%) were large (49.82 to 80.65 mm3). The intermediate and large AGs were associated with bone erosion and a high incidence of communication with a pneumatized mastoid complex (serous otitis media or meningitis). These findings suggest that AGs of sufficient size to produce bone erosion are the primary responsible lesions in adult-onset spontaneous CSF otorrhea.
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8/15. Intraosseous ganglion of the lunate.

    Intraosseous ganglion of the lunate is a relatively rare entity. Two cases are reported, in one of which a communication with the scapholunate joint was demonstrated by polytomography. curettage and bone grafting resulted in complete relief of pain.
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9/15. Intraosseous ganglia of the foot.

    The purpose of this article is to review the English language medical literature involving intraosseous ganglia and to report the rare finding of a histologically proven intraosseous ganglion found in the calcaneus. Intraosseous ganglia are rare lesions of bone seen in the metaphyses or epiphyses of long bones. The lesion is more common in the lower extremity; however, very few have been reported in the foot. The lesion is usually in close proximity to a joint, but rarely has any communication with it. The intact intraosseous ganglion is smooth and round in shape, with an opalescent color indistinguishable from soft tissue ganglia. The contents of the cyst are of a gelatinous consistency and have mucoid centers with a yellowish color. patients commonly present with intermittent pain that increases with activity. Radiographically, the lesion appears as a well-defined circular to oval radiolucent defect surrounded by a thin rim of sclerotic bone. Bone lesions with a similar radiographic appearance (giant cell tumors, aneurysmal bone cyst, and enchondromas) must be differentiated from intraosseous ganglia. Curretage of the cyst followed by packing of the defect with bone graft is the treatment most often used.
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10/15. Communicating intraosseous ganglion of the lunate.

    The authors describe a symptomatic intraosseous ganglion of the lunate communicating directly with the scapholunate joint. The communication was demonstrated by arthrography and computed tomography. This case is believed to be the first reported in which the communication was shown by arthrography. Demonstration of such a communication can obviate the need for further imaging to diagnose the lesion. A review of intraosseous ganglia of the hand and their treatment is presented.
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