Cystic adventitial disease in the popliteal artery with a joint connection to the superior tibiofibular joint: Radiological evidence to support the unifying articular theory

2015 ◽  
Vol 28 (8) ◽  
pp. 957-959
Author(s):  
Nikhil Prasad ◽  
Robert J. Spinner ◽  
Kimberly K. Amrami ◽  
Justin Winn
Keyword(s):  
Popliteal Artery ◽  
Superior Tibiofibular Joint ◽  
Radiological Evidence ◽  
Tibiofibular Joint ◽  
Joint Connection ◽  
Articular Theory

Dynamic phases of peroneal and tibial intraneural ganglia formation: a new dimension added to the unifying articular theory

2007 ◽  
Vol 107 (2) ◽  
pp. 296-307 ◽  
Author(s):  
Robert J. Spinner ◽  
Kimberly K. Amrami ◽  
Alexandra P. Wolanskyj ◽  
Nicholas M. Desy ◽  
Huan Wang ◽  
...  
Keyword(s):  
Peroneal Nerve ◽  
Ganglion Cyst ◽  
Cyst Formation ◽  
Intraneural Ganglion ◽  
Intraneural Ganglion Cyst ◽  
Articular Branch ◽  
Superior Tibiofibular Joint ◽  
Tibiofibular Joint ◽  
Joint Connection ◽  
Articular Theory

Object The pathogenesis of intraneural ganglia has been a controversial issue for longer than a century. Recently the authors identified a stereotypical pattern of occurrence of peroneal and tibial intraneural ganglia, and based on an understanding of their pathogenesis provided a unifying articular explanation. Atypical features, which occasionally are observed, have offered an opportunity to verify further and expand on the authors' proposed theory. Methods Three unusual cases are presented to exemplify the dynamic features of peroneal and tibial intraneural ganglia formation. Results Two patients with a predominant deep peroneal nerve deficit shared essential anatomical findings common to peroneal intraneural ganglia: namely, 1) joint connections to the anterior portion of the superior tibiofibular joint, and 2) dissection of the cyst along the articular branch of the peroneal nerve and proximally. Magnetic resonance (MR) images obtained in these patients demonstrated some unusual findings, including the presence of a cyst within the tibial and sural nerves in the popliteal fossa region, and spontaneous regression of the cysts, which was observed on serial images obtained weeks apart. The authors identified a clinical outlier, a case that could not be understood within the context of their previously reported theory of intraneural ganglion cyst formation. Described 32 years ago, this patient had a tibial neuropathy and was found at surgery to have tibial, peroneal, and sciatic intraneural cysts without a joint connection. The authors' hypothesis about this case, based on their unified theory, was twofold: 1) the lesion was a primary tibial intraneural ganglion with proximal extension followed by sciatic cross-over and distal descent; and 2) a joint connection to the posterior aspect of the superior tibiofibular joint with a remnant cyst within the articular branch would be present, a finding that would help explain the formation of different cysts by a single mechanism. The authors proved their hypothesis by careful inspection of a recently obtained postoperative MR image. Conclusions These three cases together with data obtained from a retrospective review of the authors' clinical material and findings reported in the literature provide firm evidence for mechanisms underlying intraneural ganglia formation. Thus, expansion of the authors' unified articular theory permits understanding and elucidation of unusual presentations of intraneural cysts. Whereas an articular connection and fluid following the path of least resistance was pivotal, the authors now incorporate dynamic aspects of cyst formation due to pressure fluxes. These basic principles explain patterns of ascent, cross-over, and descent down terminal nerve branches based on articular connections, paths of diminished resistance to fluid flow within recognized anatomical compartments, and the effects of fluctuating pressure gradients.

Dynamic phases of peroneal and tibial intraneural ganglia formation: a new dimension added to the unifying articular theory

2007 ◽  
Vol 22 (6) ◽  
pp. 1-12
Author(s):  
Robert J. Spinner ◽  
Kimberly K. Amrami ◽  
Alexandra P. Wolanskyj ◽  
Nicholas M. Desy ◽  
Huan Wang ◽  
...  
Keyword(s):  
Peroneal Nerve ◽  
Ganglion Cyst ◽  
Cyst Formation ◽  
Intraneural Ganglion ◽  
Intraneural Ganglion Cyst ◽  
Articular Branch ◽  
Superior Tibiofibular Joint ◽  
Tibiofibular Joint ◽  
Joint Connection ◽  
Articular Theory

Object The pathogenesis of intraneural ganglia has been a controversial issue for longer than a century. Recently the authors identified a stereotypical pattern of occurrence of peroneal and tibial intraneural ganglia, and based on an understanding of their pathogenesis provided a unifying articular explanation. Atypical features, which occasionally are observed, have offered an opportunity to verify further and expand on the authors' proposed theory. Methods Three unusual cases are presented to exemplify the dynamic features of peroneal and tibial intraneural ganglia formation. Results Two patients with a predominant deep peroneal nerve deficit shared essential anatomical findings common to peroneal intraneural ganglia: namely, 1) joint connections to the anterior portion of the superior tibiofibular joint, and 2) dissection of the cyst along the articular branch of the peroneal nerve and proximally. Magnetic resonance (MR) images obtained in these patients demonstrated some unusual findings, including the presence of a cyst within the tibial and sural nerves in the popliteal fossa region, and spontaneous regression of the cysts, which was observed on serial images obtained weeks apart. The authors identified a clinical outlier, a case that could not be understood within the context of their previously reported theory of intraneural ganglion cyst formation. Described 32 years ago, this patient had a tibial neuropathy and was found at surgery to have tibial, peroneal, and sciatic intraneural cysts without a joint connection. The authors' hypothesis about this case, based on their unified theory, was twofold: 1) the lesion was a primary tibial intraneural ganglion with proximal extension followed by sciatic cross-over and distal descent; and 2) a joint connection to the posterior aspect of the superior tibiofibular joint with a remnant cyst within the articular branch would be present, a finding that would help explain the formation of different cysts by a single mechanism. The authors proved their hypothesis by careful inspection of a recently obtained postoperative MR image. Conclusions These three cases together with data obtained from a retrospective review of the authors' clinical material and findings reported in the literature provide firm evidence for mechanisms underlying intraneural ganglia formation. Thus, expansion of the authors' unified articular theory permits understanding and elucidation of unusual presentations of intraneural cysts. Whereas an articular connection and fluid following the path of least resistance was pivotal, the authors now incorporate dynamic aspects of cyst formation due to pressure fluxes. These basic principles explain patterns of ascent, cross-over, and descent down terminal nerve branches based on articular connections, paths of diminished resistance to fluid flow within recognized anatomical compartments, and the effects of fluctuating pressure gradients.

An anatomically based imaging sign to detect adventitial cyst derived from the superior tibiofibular joint

2011 ◽  
Vol 24 (7) ◽  
pp. 893-902 ◽  
Author(s):  
Marie-Noëlle Hébert-Blouin ◽  
Elena Pirola ◽  
Kimberly K. Amrami ◽  
Huan Wang ◽  
Nicholas M. Desy ◽  
...  
Keyword(s):  
Superior Tibiofibular Joint ◽  
Tibiofibular Joint

Superior tibiofibular joint

2015 ◽  
pp. 447-449
Author(s):  
Mark Batt ◽  
Gurjit Bhogal
Keyword(s):  
Superior Tibiofibular Joint ◽  
Tibiofibular Joint

Expanding the spectrum of indirect trauma and superior tibiofibular joint-related intraneural ganglion cysts

2014 ◽  
Vol 27 (8) ◽  
pp. 1130-1132 ◽  
Author(s):  
Alper Cesmebasi ◽  
B. Matthew Howe ◽  
Kimberly K. Amrami ◽  
Robert J. Spinner
Keyword(s):  
Intraneural Ganglion ◽  
Indirect Trauma ◽  
Superior Tibiofibular Joint ◽  
Ganglion Cysts ◽  
Tibiofibular Joint

Intramuscular ganglia arising from the superior tibiofibular joint: CT and MR evaluation

1995 ◽  
Vol 24 (4) ◽  
Author(s):  
Stefano Bianchi ◽  
IbrahimFikry Abdelwahab ◽  
Samuel Kenan ◽  
Alicia Zwass ◽  
Giovanni Ricci ◽  
...  
Keyword(s):  
Superior Tibiofibular Joint ◽  
Tibiofibular Joint

A ganglion of the superior tibiofibular joint as a mucoid-cystic degeneration of unusual localization

1998 ◽  
Vol 6 (1) ◽  
pp. 62-66 ◽  
Author(s):  
J. Kelm ◽  
M. Ames ◽  
P. Weißenbach ◽  
C. Engel
Keyword(s):  
Cystic Degeneration ◽  
Superior Tibiofibular Joint ◽  
Tibiofibular Joint

Sequential tibial and peroneal intraneural ganglia arising from the superior tibiofibular joint

2007 ◽  
Vol 37 (1) ◽  
pp. 79-84 ◽  
Author(s):  
Robert J. Spinner ◽  
Nicholas M. Desy ◽  
Kimberly K. Amrami
Keyword(s):  
Superior Tibiofibular Joint ◽  
Tibiofibular Joint
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