Download PDF
Int J Sports Med 2008; 29(8): 692-695
DOI: 10.1055/s-2007-989440
Rapid Communication

© Georg Thieme Verlag KG Stuttgart · New York

A Synovial Ganglion of the Knee: Two Cases in Athletes

S. Dragoni1 , A. Giombini2 , A. Di Cesare3 , M. Ripani2
  • 1Department of Radiology, Institute of Sport Medicine and Science, Rome, Italy
  • 2Department of Health, University of Motor Science, Rome, Italy
  • 3Department of Physical Medicine and Rehabilitation, University of Rome, Rome, Italy
Further Information

Publication History

accepted after revision November 23, 2007

Publication Date:
22 January 2008 (online)

Also available at
    Permissions and Reprints

Abstract

The objective of the study is to describe two cases of proximal tibiofibular ganglion cysts in high level athletes. In May 2003 and March 2005 two athletes (one tennis player in the top eighty of the Italian national ranking and a gymnast belonging to the Italian rhythmic gymnastics national team) were referred to our institution complaining of postero-lateral knee discomfort and the presence of localized swelling over the fibular head and the antero-lateral aspect of the leg, with a clinically suspected diagnosis of ganglion cyst of the proximal tibiofibular joint. Ultrasonography clearly detected the fluid-filled structures while magnetic resonance imaging confirmed the diagnosis, also showing precisely the anatomic relationship between the ganglions and the surrounding structures. Both athletes underwent surgical excision and the histological examination was compatible with a proximal tibiofibular joint ganglion cyst; as yet they have had no recurrence.

Key words

synovia - joint capsule - knee - treatment - sport activity

References

  • 1 Bianchi S, Abdelwhabif I F, Kenan S, Zwass A, Ricci G, Palomba G. Intramuscular ganglia arising from the superior tibiofibular joint: CT and MR evaluation.  Skeletal Radiol. 1995;  24 253-256
    PubMedSearch in Google Scholar
  • 2 Damron T A, Rock M G. Unusual manifestations of proximal tibiofibular joint synovial cysts.  Orthopedics. 1997;  20 225-230
    PubMedSearch in Google Scholar
  • 3 De Schrijver F, Simon J P, De Smet L, Fabry G. Ganglia of the superior tibiofibular joint: report of the three cases and review of the literature.  Acta Orthop Bel. 1998;  64 233-240
    PubMedSearch in Google Scholar
  • 4 Evans J D, Neumann L, Frostick S P. Compression neuropathy of the common peroneal nerve caused by a ganglion.  Microsurgery. 1994;  15 193-195
    CrossrefPubMedSearch in Google Scholar
  • 5 Forster B B, Lee J S, Kelly S, O'Dowd M, Munk P L, Andrews G, Marchinkow L. Proximal tibiofibular joint: an often forgotten cause of lateral knee pain.  AJR. 2007;  188 W359-W366
    CrossrefPubMedSearch in Google Scholar
  • 6 Ilahi O A, Younas S A, Labbe M R, Edson S B. Prevalence of ganglion cysts originating from the proximal tibiofibular joint: a magnetic resonance imaging study.  J Arthr Rel Surg. 2003;  19 150-153
    PubMedSearch in Google Scholar
  • 7 Jerome D, McKendry R. Synovial cyst of the proximal tibiofibular joint.  J Rheum. 2000;  27 1095-1098
    PubMedSearch in Google Scholar
  • 8 Kelm J, Ames M, Weibenbach P, Engel C. A ganglion of the superior tibiofibular joint as a mucoid cystic degeneration of unusual localization. A case report and review of the literature.  Knee Surg Sports Traumat Arthrosc. 1999;  6 62-66
    PubMedSearch in Google Scholar
  • 9 Lenander K G. Ett stort ganglion pa underbenet.  Ups Lak Forh. 1891 – 1892;  27 419
    PubMedSearch in Google Scholar
  • 10 McEvedy B V. Simple ganglia.  Br J Surg. 1962;  49 585-594
    CrossrefPubMedSearch in Google Scholar
  • 11 Miskovsky S, Kaeding C, Weis L. Proximal tibiofibular joint ganglion cysts: excision, recurrence, and joint arthrodesis.  Am J Sports Med. 2004;  32 1022-1028
    CrossrefPubMedSearch in Google Scholar
  • 12 Muckart R D. Compression of the common peroneal nerve by intramuscular ganglion from the superior tibio-fibular joint.  J Bone Joint Surg. 1976;  58 241-244
    PubMedSearch in Google Scholar
  • 13 O'Rourke P J, Byrne J J. Giant ganglion of the proximal tibiofibular joint: a case report.  Ir J Med Sci. 1995;  164 295-296
    PubMedSearch in Google Scholar
  • 14 Pagnoux C, Lhotellier L, Marek J J, Ballard M, Chazerain P, Ziza J M. Synovial cysts of the proximal tibiofibular joint: three cases reports.  Joint Bone Spine. 2002;  69 331-333
    CrossrefPubMedSearch in Google Scholar
  • 15 Resnick D, Newell J D, Guerra J JR, Danzig L A, Niwayama G, Goergen T G. Proximal tibiofibular joint: anatomic-pathologic-radiographic correlation.  Am J Roentgenol. 1978;  131 133-138
    PubMedSearch in Google Scholar
  • 16 Rozbruch S R, Chang V, Bohne W H, Deland J T. Ganglion cysts of the lower extremity: an analysis of 54 cases and review of the literature.  Orthopedics. 1998;  21 141-148
    PubMedSearch in Google Scholar
  • 17 Schwimmer M, Edelstein G, Heiken J P, Gilula L A. Synovial cysts of the knee. CT evaluation.  Radiology. 1985;  154 175-177
    PubMedSearch in Google Scholar
  • 18 Spinner R J, Mokhtarzadeh A, Schiefer T K, Krishnan K G, Kliot M, Amrami K K. The clinico-anatomic explanation for tibial intraneural ganglion cysts arising from the superior tibiofibular joint.  Skeletal Radiol. 2007;  36 281-292
    CrossrefPubMedSearch in Google Scholar
  • 19 Stack R E, Bianco A J, Mc Carthy C S. Compression of the common peroneal nerve by ganglion cysts.  J Bone Joint Surg [Am]. 1965;  47 773-778
    PubMedSearch in Google Scholar
  • 20 Tschirch F TC, Schmid M R, Pirrmann W A, Romero J, Hodler J, Zanetti M. Prevalence and size of meniscal cysts, ganglionic cysts, synovial cysts of the popliteal space, fluid filled bursae, and other fluid collections in asymptomatic knees on MR imaging.  AJR. 2003;  180 1431-1436
    PubMedSearch in Google Scholar
  • 21 Weber D, Friederich N F, Nidecker A, Muller W. Deep posterior knee pain caused by a ganglion of the popliteus tendon – a case report.  Knee Surg Sports Traum Artrosc. 1996;  4 157-159
    PubMedSearch in Google Scholar

Dr. Stefano Dragoni

Institute of Sport Medicine and Science
Department of Radiology

Largo P. Gabrielli, 1

00197 Rome

Italy

Fax: + 39 36 85 92 56

Email: stefano.dragoni@coni.it