Intraneural ganglion cysts of obturator nerve causing obturator neuropathy
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NEURO-IMAGES Intraneural ganglion cysts of obturator nerve causing obturator neuropathy Jyoti Sureka • Sanuj Panwar • Indira Mullapudi Received: 26 November 2011 / Accepted: 10 December 2011 / Published online: 3 February 2012 Ó Belgian Neurological Society 2012 A 26-year-old gentleman presented with thigh pain and progressive adductor muscles weakness. A magnetic reso- nance imaging of the pelvis revealed multiple small cysts along the course of right obturator nerve extending along the articular branch to communicate the ipsilateral anter- omedial hip joint (Fig. 1a, b). Atrophy and denervation hyperintensity of ipsilateral adductor brevis and magnus muscles were also noted (Fig. 2a, b). Intra-neural obturator ganglion cysts, although very rare [1], do exist and clini- cally symptoms often mimic with hip or lumbosacral disc disease which causes delay in diagnosis [1, 2]. These are benign mucoid containing cysts within the epineurium of the nerves compressing the nerve fascicles towards the periphery [3]. An effort must be made to identify and Fig. 1 a, b 26-year-old male with right thigh pain and weakness. Contiguous coronal T2-weighted short tau inversion-recovery (STIR) images depict multiple small intraneural cyst within the right obturator nerve (black arrows) extending along the articular branch to communicate the ipsilateral anteromedial hip joint (white arrows). Note the normal left obturator nerve (yellow arrows) J. Sureka (&) Á I. Mullapudi Department of Radiology, Christian Medical College and Hospital, Vellore, Tamilnadu, India e-mail: [email protected] S. Panwar Department of Neurology, Christian Medical College, Vellore, Tamilnadu, India 123 Acta Neurol Belg (2012) 112:229–230 DOI 10.1007/s13760-012-0041-1
Transcript of Intraneural ganglion cysts of obturator nerve causing obturator neuropathy
NEURO-IMAGES
Intraneural ganglion cysts of obturator nerve causing obturatorneuropathy
Jyoti Sureka • Sanuj Panwar • Indira Mullapudi
Received: 26 November 2011 / Accepted: 10 December 2011 / Published online: 3 February 2012
� Belgian Neurological Society 2012
A 26-year-old gentleman presented with thigh pain and
progressive adductor muscles weakness. A magnetic reso-
nance imaging of the pelvis revealed multiple small cysts
along the course of right obturator nerve extending along
the articular branch to communicate the ipsilateral anter-
omedial hip joint (Fig. 1a, b). Atrophy and denervation
hyperintensity of ipsilateral adductor brevis and magnus
muscles were also noted (Fig. 2a, b). Intra-neural obturator
ganglion cysts, although very rare [1], do exist and clini-
cally symptoms often mimic with hip or lumbosacral disc
disease which causes delay in diagnosis [1, 2]. These are
benign mucoid containing cysts within the epineurium of
the nerves compressing the nerve fascicles towards the
periphery [3]. An effort must be made to identify and
Fig. 1 a, b 26-year-old male with right thigh pain and weakness.
Contiguous coronal T2-weighted short tau inversion-recovery (STIR)
images depict multiple small intraneural cyst within the right
obturator nerve (black arrows) extending along the articular branch
to communicate the ipsilateral anteromedial hip joint (white arrows).
Note the normal left obturator nerve (yellow arrows)
J. Sureka (&) � I. Mullapudi
Department of Radiology, Christian Medical College and
Hospital, Vellore, Tamilnadu, India
e-mail: [email protected]
S. Panwar
Department of Neurology, Christian Medical College, Vellore,
Tamilnadu, India
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Acta Neurol Belg (2012) 112:229–230
DOI 10.1007/s13760-012-0041-1
remove the extension of the intra-neural ganglion cyst into
the articular branch as the latter can result in intra-neural
recurrences [1, 2].
Conflict of interest None.
References
1. Swartz KR, Wilson D, Boland M, Fee DB (2009) Proximal sciatic
nerve intraneural ganglion cyst. Case Report Med 2009:810973
2. Spinner RJ, Hebert-Blouin MN, Trousdale RT, Midha R, Russell
SM et al (2009) Intraneural ganglia in the hip and pelvic region:
clinical article. J Neurosurg 111(2):317–325
3. Chick G, Alnot JY, Silbermann-Hoffman O (2001) Intraneural
mucoid pseudocysts. A report of ten cases. J Bone Jt Surg Br
83(7):1020–1022
Fig. 2 a, b Axial T2-weighted STIR images show the volume loss and hyperintensity of adductor brevis (AB) and magnus (AM) muscles. Again
the cysts are seen to be extending along the anterior branch (black arrow)
230 Acta Neurol Belg (2012) 112:229–230
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