After injecting 1% xylocaine into the spinoglenoid notch under ultrasonographic guidance, the posterior shoulder pain resolved. Therefore, we concluded that the protrusion of an intraosseous cyst of the glenoid into the spinoglenoid notch was a cause of the pain, and performed curettage. (a, b) Microscopic section of the cyst wall shows that the wall contained connective tissue, including collagen fibers and a few fibroblasts, and that the inner layer of connective tissue had myxoid change. When sacs of fluid form inside an individual's joints, it is known as a subchondral bone cyst. These findings were consistent with an intraosseous ganglion. Subchondral bone cysts (SBCs) are sacs filled with fluid that form inside of joints such as knees, hips, and shoulders. please consult your Orthopedician he will examine and treat you accordingly. The area at which he experienced spontaneous shoulder pain was innervated by the suprascapular nerve (Figure 1(a)). As a result, we could perform curettage of the cyst wall, which relieved the patient of the symptom. Consequently, the shoulder pain was resolved promptly without suprascapular nerve complications, and the cyst was histologically diagnosed as an intraosseous ganglion. It mainly occurs in middle-aged people, and the most common site is the lower end of the tibia [4, 5]. Review articles are excluded from this waiver policy. Only 13 cases around the shoulder have been described in the literature. However, if the cyst is inside the shoulder joint certain tests such as ultrasound, MRI, may be required for its diagnosis. (b) MR T2-weighted sagittal image of the left shoulder shows that the intraosseous lesion is linked to the spinoglenoid notch. They are the equivalent of soft tissue ganglia. Consequently, the shoulder pain was resolved promptly without suprascapular nerve complications, and the cyst was histologically diagnosed as an intraosseous ganglion. Biodegradable implants lead to problems such as cyst formation, soft-tissue inflammation, loose implant fragments or local osteolysis. The area was drilled and a curette was used to remove any material but little was extracted. Introduction. But this may be a temporary and soon the pain occurs once the medicines are stopped. ... Intraosseous operation - resection of the cyst with parallel bone graft and application of Ilizarov's apparatus. It is more prevalent in men. May extend through the cortex into the joint, esp. A subchondral cyst is an intraosseous epiphyseal synovial fluid-filled void prevalent in osteoarthritis that may attain a diameter of 1-15 mm or more in size with the cyst’s longest axis usually along the coronal plane in the craniocaudal axis. Intraosseous ganglia located in the scaphoid have rarely been described in the literature. A subchondral cyst (Fig. A rotator cuff tear with an intraosseous ganglion was diagnosed and operated on. On visiting our hospital, he complained of continuous posterior shoulder pain at rest; however, he could move his shoulder actively at 160 degrees of flexion and abduction, 60 degrees of external rotation at the side, and 90 degrees of external rotation at abduction and could maintain muscle strength around the shoulder on manual muscle testing. Ganglion cysts are also common in people having osteoarthritis of shoulder. These cysts should be considered causes of unexplained rotator cuff weakness in young patients, although they may also be discovered incidentally on MRI. Few reports have presented the characteristics of an intraosseous ganglion, such as its incidence and etiology, and this ganglion is considered to be relatively rare. It is because of the constant stress put on the shoulder joint. Intraosseous foreign body granuloma in rotator cuff repair with bioabsorbable suture anchor. Needle aspiration for the cyst was performed using an 18-gauge needle under ultrasonographic guidance; however, no aspirate was obtained. A 47-year-old man with left shoulder pain developed an intraosseous cyst in the left glenoid, which came into contact with the suprascapular nerve. Figure 3: MRI of the knee joint T2 Image (a) and (b) showing periarticular intraosseous cyst. Intraosseous ganglion cyst of the carpal bones represents a rare cause of wrist pain. Another theory put forward suggests a flaw in the joint space which allows the tissue to protrude out. Intraosseous ganglion cysts are rare causes of wrist pain. (b) Intraoperative photograph of the posterior shoulder shows the suprascapular nerve after splitting the infraspinatus (yellow arrow). An extraosseous cyst was located over the posterior glenoid neck, which had capsules filled with a transparent gelatinous substance. The histological finding was an inner layer of fibrous connective tissue without any lining cells. @article{Yi2009IntraosseousGO, title={Intraosseous ganglion of the glenoid causing suprascapular nerve entrapment syndrome: a case report. Ways to Stop This Pain, Causes of Hiccups at Night During Pregnancy: How Do You Stop It, There are several conditions that begin with fever as the only symptom. Only 13 cases around the shoulder have been described in the literature. The patient was a 47-year-old woman with a painful left shoulder with a limited range of motion. Author information: (1)Department of Orthopaedic Surgery, University of Göttingen, Medical Center, UMG, Germany. The spinoglenoid notch was directly visualized after splitting the teres minor and infraspinatus muscles, and the suprascapular nerve and cyst were identified at the spinoglenoid notch (Figure 3(b)). This case demonstrated that the intraosseous ganglion of the glenoid was a benign lesion but could be a cause of suprascapular nerve entrapment syndrome. The common stalk feeds fluid into the tumor-like mass. The suprascapular nerve was raised upward by the cyst wall present below the nerve. Tam W, Resnick D, Haghighi P, Vaughan L: Intraosseous ganglion of the patella. However, if the cyst is inside the shoulder joint certain tests such as ultrasound, MRI, may be required for its diagnosis. The exact reason why a ganglion develops in shoulder is not known. Curettage was performed under general anesthesia in the right lateral position (Figure 3(a)). More often than not, paralabral cysts of the shoulder are an infrequent finding on MRI or MR Arthrogram. Clinical presentation Patients may have mild localized pain. The cysts may extend into the suprascapular or spinoglenoid notches and compress the suprascapular nerve. Daichi Ishimaru, Akihito Nagano, Nobuo Terabayashi, Yutaka Nishimoto, Haruhiko Akiyama, "Suprascapular Nerve Entrapment Caused by Protrusion of an Intraosseous Ganglion of the Glenoid into the Spinoglenoid Notch: A Rare Cause of Posterior Shoulder Pain", Case Reports in Orthopedics, vol. On magnetic resonance imaging a cystic lesion of the proximal humerus was detected. After releasing the nerve gently from the cyst (Figure 3(c)), an incision was made at the cyst wall, and gelatinous material flowed out from the cyst. Surgical treatment of this pathologic condition yields good results and a low recurrence rate. Therefore, in the present case, it was believed that the ganglion did not occur in the soft tissue around the spinoglenoid notch and then penetrate into the glenoid, but it occurred primarily inside the glenoid and protruded into the spinoglenoid notch accompanied with bone destruction over a long period. Suprascapular Nerve Entrapment Caused by Protrusion of an Intraosseous Ganglion of the Glenoid into the Spinoglenoid Notch: A Rare Cause of Posterior Shoulder Pain, Department of Orthopaedic Surgery, Gifu University School of Medicine, Yanagido 1-1, Gifu, Gifu Prefecture, Japan, R. E. Boykin, D. J. Friedman, L. D. Higgins, and J. J. P. Warner, “Suprascapular neuropathy,”, S. Lichtenberg, P. Magosch, and P. Habermeyer, “Compression of the suprascapular nerve by a ganglion cyst of the spinoglenoid notch: the arthroscopic solution,”, G. R. Fisk, “Bone concavity caused by a ganglion,”, A. Sakamoto, Y. Oda, and Y. Iwamoto, “Intraosseous ganglia: a series of 17 treated cases,”, M. Urayama, E. Itoi, H. Watanabe, K. Sato, and J. Kamei, “Intraosseous ganglion of the glenoid,”, M. Kligman and M. Roffman, “Intraosseous ganglia of glenoid,”, K. Murata, Y. Nakagawa, T. Suzuki, M. Kobayashi, S. Kotani, and T. Nakamura, “Intraosseous ganglion about to cause a fracture of the glenoid: a case report,”, C. Tudisco and S. Bisicchia, “Intraosseous ganglion with impending fracture of the glenoid,”, J. W. Yi, N. S. Cho, and Y. G. Rhee, “Intraosseous ganglion of the glenoid causing suprascapular nerve entrapment syndrome: a case report,”, J. E. Wong, S. A. Aviles, and C. B. Ma, “Intraosseous ganglion of the glenoid,”, K. J. Westerheide, R. M. Dopirak, R. P. Karzel, and S. J. Snyder, “Suprascapular nerve palsy secondary to spinoglenoid cysts: results of arthroscopic treatment,”, U. Helwig, S. Lang, M. Baczynski, and R. Windhager, “The intraosseous ganglion A clinical-pathological report on 42 cases,”, F. Schajowicz, M. Clavel Sainz, and J. (b) Radiograph of the left shoulder shows a radiolucent cystic lesion in the superior glenoid. This report describes a case of an intraosseous ganglion about to cause fracture of the glenoid. The cysts appear in chronic osteoarthritis cases and tend to progress in size and number as the overlying cartilage surface thins. After the operation rehabilitating exercises will help the shoulder to perform all movement. The cysts were … This study was approved by the Human Ethics Committee of Gifu University (no. This compression can result in atrophy of the supraspinatus or infraspinatus muscle or both. 2017, Article ID 1704697, 5 pages, 2017. https://doi.org/10.1155/2017/1704697, 1Department of Orthopaedic Surgery, Gifu University School of Medicine, Yanagido 1-1, Gifu, Gifu Prefecture, Japan. Epidemiology Tends to occur in middle age. A 10 cm skin incision is made at the posterior glenohumeral joint. A lipoma is a slow-growing, fatty lump that's most often situated between your skin and the underlying muscle layer. We describe a case of suprascapular nerve entrapment caused by protrusion of an intraosseous ganglion of the glenoid into the spinoglenoid notch. Besides, anti inflammatory medicines may also have side effects if they are taken for long time. Plain anteroposterior radiography of the left shoulder showed a circular lesion with marginal osteosclerosis at the glenoid (Figure 1(b)). The nerve was stretched and edematous, and it highly adhered to the cyst wall. GROSS PATHOLOGY. This report represents the first published case of an intraosseous foreign body granuloma in the humeral head after arthroscopic rotator cuff tear fixation with a poly-l-lactide (PLLA) suture anchor. Mean average age of patients is 42 years. Intraosseous ganglia are rare lesions that can cause pain and leave patients susceptible to pathologic fracture. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. }, author={Jin Woong Yi and Nam Su Cho and Y. Rhee}, journal={Journal of shoulder and elbow surgery}, year={2009}, volume={18 3}, pages={ e25-7 } } We reported a case of suprascapular nerve entrapment caused by protrusion of an intraosseous ganglion of the glenoid into the spinoglenoid notch, which is a rare cause of posterior shoulder pain. The most common is the paralabral cyst that results from a glenoid labral tear. We believe that open surgery including curettage is a useful treatment option for a ganglion inside bone and present very close to the suprascapular nerve. 3-5cm, bulging, with a white outer fibrous surface, usually multilocular. The cyst is just underneath the skin near a joint. This case demonstrated that the intraosseous ganglion of the glenoid was a benign lesion but could be a cause of suprascapular nerve entrapment syndrome. The patient gave informed consent and permission for this publication. Only 13 cases around the shoulder have been described in the literature. While they’re usually harmless, they can occasionally be cancerous. Epidemiology Tends to occur in middle age. Intraosseous ganglion of the glenoid causing suprascapular nerve entrapment syndrome: a case report. Up to 7cm in size, usu. This study was based on a series of 4 patients, all of whom had wrist pain because of intraosseous ganglion cysts. An extraosseous cyst was located over the posterior glenoid neck, which had capsules filled with a transparent gelatinous substance. Commonly these lesions are found just beneath the attachments of the cruciate ligaments and are frequently associated with similar appearing soft-tissue ganglia nearby or with additional intraosseous ganglia in the vicinity [2]. These cysts are produced in areas of damaged articular cartilage, subjacent to the underlying subarticular cortical plate. (a) Magnetic resonance (MR) T2-weighted axial image of the left shoulder shows a high intensity area at the glenoid. Intraosseous ganglia are uncommon in skeletal sites such as the carpal bones, wrist, proximal femur, distal tibia, and glenoid bone. An intraosseous ganglion (plural: ganglia) is a benign subchondral radiolucent lesion without degenerative arthritis. A. Slullitel, “Juxta-articular bone cysts (intra-osseous ganglia): a clinicopathological study of eighty-eight cases,”. The fluid is sticky, jelly like colorless substance. Intraosseous ganglia are intramedullary, non-neoplastic, subchondral cystic lesions containing mucoid fluid. Second edition by Lippincott Williams & Wilkins. We present the first reported case of complete, spontaneous resolution of a massive AC joint cyst without the need for surgical intervention. Intervention and outcome: A trial of passive care was conducted, including Ganglion cyst in shoulder is not common, but when present can produce discomforting pain and weakness in shoulder. even described an intraosseous rheumatoid nodule with avidity for gallium-67 citrate in the rib of a 9-year-old boy with rheumatoid nodulosis. Recently, a simple and safe less invasive arthroscopic approach was reported for patients with spinoglenoid ganglion cysts [11]. The cyst is removed with arthroscopic procedure. The histological examination of cystic mass was expressed as ganglion. Her symptoms did not improve after non-operative treatment. Ganglion cysts can decrease or increase in size and sometimes they disappear completely. Intraosseous ganglia of the glenoid are rare, and their etiology is unknown. 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