DEFINITION AND PATHOGENESIS
- Meniscal and ligamentous or capsular myxoid degeneration as a result of trauma, or synovial outpouchings as a result of developmental or degenerative etiology
- Symptomatic non-neoplastic lesions which require no tumor work up
- ± pain, limitation of activities or motion, to asymptomatic periarticular swelling (often assymptomatic)
- Dorsally in the wrist, association with the posterior interosseous nerve may be the etiology of the pain
- Proximal tibiofibular joint ganglia may cause anterior compartment syndrome or peroneal nerve compression
- Spinoglenoid ganglia compress the inferior branch of the suprascapular nerve with atrophy of infraspinatus and ER weakness
- Often associated with posterior labral tear although direct communication with shoulder joint is rare
- Compression of the radial or posterior interosseous nerve by ganglia in the region of the supinator muscle reported
- Compression of the axillary nerve by a paraglenoid labral cyst reported
- Compression of the sciatic nerve by a posterior hip cyst reported
- Compression of the ulnar nerve by a ganglia of the ulnar groove reported
- Selective motor neuropathy of the median nerve in the carpal tunnel has been reported
- Compression of the palmar cutaneous nerve reported
- May be associated with tarsal tunnel syndrome (most from the talocalcaneal joint ± coalition)
- Medial plantar nerve dysesthesia, ± lateral plantar and medial calcaneal branch dysesthesias
- Ganglia of the foot may arise from the TMTJ
- Ganglion cysts may be associated with palpable snapping with motion of an adjacent joint
- Meniscal cysts can become quite large ( ³10cm) and MRI will often reveal intraarticular pathology (meniscal tears)
- Assoiciated with ~7% of meniscal tears
- Arthroscopic decompression ± open excision (in larger cysts)
- Bilateral cysts have been reported
- ACL and PCL ganglion cysts can be a cause of knee pain, ? ROM
- Intraneural ganglions/mucoid cysts/nerve sheath ganglia have been reported in median, ulnar, radial, posterior interosseous nerves, and within the brachial plexus with compressive sxs
- Synovial cysts of the spine (± hemorrhagic component) involving facet joints may cause pain
- ± radicular sxs
- ± trauma hx
- A giant synovial cyst remotely occurring after THA has been associated with development of DVT
- Has been reported after A1 pulley (trigger finger) release
- Lesion will often transilluminate
- A ganglion most often occurs on the dorsal (60-70%) and volar surfaces of the wrist in persons between 25-45 yrs (M:F = 3.4:1)
- Specific (and other) locations include:
- Over the scapholunate ligament (may arise in various locations, connecting with a long stalk)
- Volar radiocarpal joint between the FCR and APL tendons
- Volar capsule of the scaphotrapezial joint
- Volar annular A1 pulley (usually 3-8mm in size)
- Mucous cyst at the dorsal DIPJ (MF most commonly involved)
- Extensor tendon ganglia, esp over the metacarpals
- Flexor tendon ganglia, esp the middle finger
- Unusual location: palmar MCPJ, PIPJ (¾ responded to aspiration alone)
- Ossification of a ganglion cyst in a small finger has been reported
- High T2 signal uptake ± cartilaginous or ligamentous intraarticular abnormalities on MRI
- May occur at the insertion site of tendons and erode bone
- Posterior horn medial meniscal cysts may be confused with PCL systs because of close proximity to the PCL
- Erosion of bone can occur, even with intra-articular ganglia (eg, ACL cysts)
- Paralabral cysts of the acetabulum associated with labral disorders
- US imaging has been reported useful in choosing appropriate tx of flexor tendon sheath ganglions
- Solitary cyst/anechoid mass: aspirate (~8% will require excision)
- Solid tumor/heterogeneous hypoechoic mass: surgical excision (usually not a ganglion)
- No echoic mass: probably tenosynovitis
- Gelatinous material in meniscal or ligamentous cysts to viscous joint fluid in Baker's cysts
- Contains glucosamine, albumin, globulin, hyaluronic acid
- A mucin duct can often be found on surgical exploration, transversing through the joint capsule
- Acellular material, few fibroblasts and mesenchymal cells
- Outer wall with randomly oriented layers of collagen fibers
DIFFERENTIAL CLINICOPATHOLOGIC DIAGNOSIS
- These non-neoplastic processes pose no diagnostic dilemma unless in the case of very small wrist ganglia which may be confused with sprains of the scapholunate ligament or early carpal instability
- Carpometacarpal boss (± associated ganglion)
- Dorsal retinacular ganglia of the 1st extensor compartment in pts with DeQuervain's stenosing tenosynovitis require release of thumb extensor tendon adhesions (and avoidance of radial sensory nerve)
- Traumatic venous or arterial aneurysm
- Rheumatoid cyst
DISEASE COURSE AND TREATMENT
- Treatment of underlying pathologic condition in meniscal and Baker's cysts
- Both meniscal cysts and the Baker's cyst may require open tx (or arthroscopic decompression through the defect)
- ACL and PCL cysts usually ammendable to arthroscopic decompression
- Needle aspiration/puncture ± steroid injection (both with ~33% "cure") and digital massage (except in volar ganglia near the radial artery), esp in A1 pulley ganglia may result in cure
- May disappear spontaneously, esp in children (22/29)
- Detection of small ganglia about the wrist may be difficult
- Resection of DIPJ osteophytes advocated in mucous cyst excision
- Dorsal wrist ganglia may be associated with early carpal instability and their removal may be blamed for the instability after a routine ganglion excision
- Tx of dorsal wrist ganglia with a silk thread crossed through the cyst X 3 weeks and massage has been described
- Pseudoaneurysm of the radial artery has been reported a complication of wrist ganglion excision (let down the tourniquet!)
- 96% cure rate with excision of a small cuff of tissue along with the stalk
- Nail deformity not present preoperatively may occur after mucous cyst excision
- Injection with fibrin glue has been reported as successful in 76% of patients
- Injection of hyaluronidase + methylprednisolone with cure rate of 89% (57% reported with methylprednisolone alone)
- In adults, usually associated with intraarticular pathology, such as meniscal tears or DJD, responding to tx of these abnormalities, occasionally requiring ablation surgically; occasionally huge or extensive
- Fluid is between the semimembranosis and the medial gastrocnemius head
- In children, observation is the rule
- Septic Baker's cyst a complication of septic gonarthritis
- 'Complicated Baker's Cyst'
- Refers to a variant resembling infection, but representing necrotic debri
- Air within the cyst (but no infection)
- Gangllia too small to palpate but suspected because of location and exam
Adolfsson L: Ganglion cyst communicating with the elbow joint presenting as a distal forearm tumour. J Hand Surg 22B:552-4,1997.
Allieu Y, Cenac PE: Peripheral nerve mucoid degeneration of the upper extremity. J Hand Surg 14A:189-94,1989.
Al-Khawashki H, Hooper G: The distribution of fibrous flexor sheath ganglions. J Hand Surg 22B:226-7,1997.
Andonopoulos AP, Yarmenitis S, Sfountouris H, Siamplis D, Zervas C, Bounas A: Baker's cyst in rheumatoid arthrits: an ultrasonographic study with high resolution technique. Clin Exp Rheumatol 13:633-6,1995.
Angelides AC, Wallace PF: The dorsal ganglion of the wrist: its pathogenesis, gross and microscopic anatomy, and surgical treatment. J Hand Surg 1A:228-35,1976.
Awwad EC, Sundaram M, Bucholz RD: Post-traumatic spinal synovial cyst with spondylolysis: CT features. J Comput Assist Tomogr 13:334-7,1989.
Baker WM: On the formation of synovial cysts in the leg in connection with diseases of the knee-joint. Clin Orthop 299:2-10,1994. (From St Barholemew's Hospital Report 13:245-61,1877.)
Barrie HJ: The pathogenesis and significance of meniscal cysts. J Bone Joint Surg 61B:184-9,1979.
Benedetti GE, Parson TW, Smith DK: Aperiosteal ganglion of the distal part of the radius. A case report. J Bone Joint Surg 78A:1415-8, 1996.
Bianchi S, Abdelwahab IF, Zwass A, Giacomello P: Ultrasonographic evaluation of wrist ganglia. Skeletal Radiol 23:201-3,1994.
Bianco AJ Jr: Low-back pain and sciatica: diagnosis and indications for treatment. J Bone Joint Surg 50A:170-81,1968.
Bolhuis HW, Van der Werf TS, Tjabbes T, Ponsen RJ, Van de Loo RA: Giant synovial cyst of the hip joint presenting with femoral vein compression. Neth J Surg 42:88-91,1990.
Brown RE, Zook EG, Russell RC, Kucan JO, Smoot EC: Fingernail deformities secondary to ganglions of the distal interphalangeal joint (mucous cysts). Plast Reconstr Surg 87:718-25,1991.
Bui-Mansfield L, Youngberg R: Intraarticular ganglion of the knee: prevalence, presentation, etiology, and management. AJR 168:123-7,1997.
Burk DL, Jr, Dalinka M, Kanal E, Schiebler ML, Cohen EK, Prorok RJ, Gefter WB, Kressel HY: Meniscal and ganglion cysts of the knee: MR evaluation. AJR 150:331-6,1988.
Busch CC, Cable BM, Dabezies EJ: Ganglions of the proximal interphalangeal joint. Orthopedics 23:839-40,2000.
Butler MB, Fuchigami KD, Chako A: MRI of posterior knee masses. Skeletal Radiol 25:309-17,1996.
Byström S, Adalberth G, Milbrink J: Giant synovial cyst of the hip: an unusual presentation with compression of the femoral vessles. Can J Surg 38:368-70,1995.
Cardinal E, Buckwalter KA, Braunstein EM, Mih AD: Occult dorsal carpal ganglion: comparison of US and MR imaging. Radiology 193:259-62,1994.
Chen SY, Kamatani N, Kashiwazaki S: Multiple extra-articular synovial cyst formation: case report and review of the literature. Ann Rheum Dis 57:169-71,1998.
Clay NR, Clement DA: The treatment of dorsal wrist ganglia by radical excision. J Hand Surg 13B:187-91,1988.
Conroy BP, Sharpe RC, Kenter K, Griffiths HJ: Radiologic case study. Orthopedics 23:288,91,6,2000.
Crass JR, van de Vegte GL, Harkavy LA: Tendon echogenicity: ex vivo study. Radiology 167:499-501,1988.
Crawford RJ, Gupta A, Resitano G, Burke FD: Mucous cyst of the distal interphalangeal joint: treatment by simple excision or excision and skin flap. J Hand Surg 15B:113-4,1990.
Crowley B, Gschwind CR, Storey C: Selective motor neuropathy of the median nerve caused by a ganglion in the carpal tunnel. J Hand Surg 23B:611-2,1998.
Curl WW: Popliteal cysts: historical background and current knowledge. J Am Acad Orthop Surg 4:129-33,1996.
De Flaviis L, Nessi R, Del Bo P, Calori G, Balconi G: High-resolution ultrasonography of wrist ganglia. J Clin Ultrasound 15:17-22,1987.
Doppman JL: Baker's cyst and the normal gastrocnemio-semimembranous bursa. AJR 94:646-52,1965.
Fehrman DA, Orwin JF, Jennings RM: Suprascapular nerve entrapment by ganglion cyst: a report of six cases with arthroscopic findings and reveiw of the literature. Arthroscopy 11:727-34,1995.
Feldman MD, Rotman MB, Manske PR: Compression of the deep motor branch of the ulnar nerve by a midpalmar ganglion. Orthopedics 18:65-7,1995.
Fritz GR, Stern PJ, Dickey M: Complications following mucous cyst excision. J Hand Surg 22B:222-5,1997.
Fritz R, Helms C, Steinbach L, Genant H: Surprascapular nerve entrapment: evaluation with MR imaging. Radiology 182:437-44,1992.
Gang RK, Makhlouf S: Treatment of ganglia by a thread technique. J Hand Surg 13B:184-6,1988.
Garneau R, Renfrew D, Moore T, El-Khoury G, Nepola J, Lemke J: Glenoid labrum: evaluation with MR imaging. Radiology 179:519-22,1991.
Giele H, Le Viet D: Intraneural mucoid cysts of the upper limb. J Hand Surg 22B:805-9,1997.
Gillies RM, Burrows C: Nerve sheath ganglion of the superficial radial nerve. J Hand Surg 16B:94-5,1991.
Gingrass MK, Brown RE, Zook EG: Treatment of fingernail deformities secondary to ganglions of the distal interphalangeal joint. J Hand Surg 20:502-5,1995.
Glasgow MM, Allen PW, Blakeway C: Arthroscopic treatment of cyst of the lateral meniscus. J Bone Joint Surg 75B:299-302,1993.
Goss T, Aronow M, Coumas J: The use of MR imaging to diagnose suprascapular nerve entrapment caused by a ganglion. Orthopedics 17:359-62,1994.
Greendyke SD, Wilson M, Shepler TR: Anterior wrist ganglia from the scaphotrapesial joint. J Hand Surg 17A:487-90,1992.
Gunther SF: Dorsal wrist pain and the occult scapholunate ganglion. J Hand Surg 10A:697-703,1985.
Haller J, Resnick D, Greenway G, Chevrot A, Murray W, Haghighi P, Sartoris DJ, Chen CK: Juxtaacetabular ganglionic (or synovial) cysts: CT and MR features. J Comput Assist Tomogr 13:976-83,1989.
Hashizume H, Nishida K, Nanba Y, Inoue H, Konishiike T: Intraneural ganglion of the posterior interosseous nerve with lateral elbow pain. J Hand Surg 20B:649-51,1995.
Haskin JS, Jr: Ganglion-related compression neuropathy of the palmar cutaneous branch of the median nerve: a report of two cases. J Hand Surg 19A:827-8,1994.
Helbich TH, Breitenseher M, Trattnig S, Nehrer S, Erlacher L, Kainberger F: Sonomorphologic variants of popliteal cysts. J Clin Ultrasound 26:171-6,1998.
Hermansdorfer JD, Greider JL, Dell PG: A case report of a compressive neuropathy of the radial sensory nerve caused by a ganglion cyst at the elbow. Orthopedics 9:1005-9,1986.
Hsu RWW, Chen CYC, Shen WJ: Ulnar nerve palsy due to concomitant compression by the anconeus epitrochlearis muscle and a ganglion. Orthopedics 27:227-8,2004.
Hughston JC, Baker CL, Mello W: Popliteal cyst: a surgical approach. Orthopedics 14:147-50,1991.
Iannotti J, Ramsey M: Arthroscopic decompression of a ganglion cyst causing suprascapular nerve compression. Arthroscopy 12:739-45,1996.
Inhofe PD, Moneim MS: Compression of the ulnar nerve at the elbow by an intraneural cyst: a case report. J Hand Surg 21A:1094-6,1996.
Jackson DE Jr, Atlas SW, Mani JR, Norman D: Intraspinal synovial cysts: MR imaging. Radiology 170:527-30,1989.
Janzen DL, Peterfy CG, Forbes JR, Tirman PFJ, Genant HK: Cystic lesions around the knee joint: MR imaging findings. AJR 163:155-61,1994.
Jaradeh S, Sanger JO, Maas EF: Isolated sensory impairment of the thumb due to an intraneural ganglion cyst in the median nerve. J Hand Surg 20B:475-8,1995.
Johnson LJ, Dyk EV, Johnson CA, Bays BM, Gully SM: The popliteal bursae (Baker's cyst): an arthroscopic perspective and epidemiology. Arthroscopy 13:66-72,1997.
Jones HG, Sarasin SM, Jones SA, Mullaney P: Acetabular paralabral cyst as a rare cause of sciatica. A case report. J Bone Joint Surg 91A:2696-9,2009.
Kaempffe F, D'Amato C: An unusual intra-articular ganglion of the knee with interosseous extension. A case report. J Bone Joint Surg 71A:773-5, 1989.
Kaneko K, Inoue Y: Haemorrhagic lumbar synovial cyst. J Bone Joint Surg 82B:583-4,2000.
Kasdan ML, Stallings SP, Leis VM, Wolens D: Outcome of surgically treated mucous cysts of the hand. J Hand Surg 19A:504-7,1994.
Kato H, Minami A, Hirahi K, Kasashima T: Treatment of flexor tendon sheath ganglions using ultrasound imaging. J Hand Surg 22A:1027-33,1997.
Kim CW, Haghighi P, Botte MJ, Resnick D, Meyer RS: Large medial knee mass in a 61-year-old man. Clin Orthop 362:251-5, 61-3, 1999.
Ko JY, Shih CH, Chen WJ, Yamamoto R: Coracoid impingement caused by a ganglion from the subscapularis tendon. A case report. J Bone Joint Surg 76A:1709-11, 1994.
Korman J, Pearl R, Hentz VR: Efficacy of immobilization following aspiration of carpal and digital ganglions. J Hand Surg 17:1097,9,1992.
Kumar A, Bickerstaff DR, Grimwood JS, Suvarna SK: Mucoid cystic degeneration of the cruciate ligament. J Bone Joint Surg 81B:304-5,1999.
Laine HR, Harjula A, Peltokallio P: Ultrasound in the evaluation of the knee and patellar regions. J Ultrasound Med 6:33-6,1987.
Lawson GM, Salter DM, Hooper G: The histopathology of fibrous flexor sheath ganglia. J Hand Surg 19B:258-60,1994.
Lektraknl N, Skaf A, Yeh L, Roger B, Schweitzer M, Blasbalg R, Resnick D: Pericruciate meniscal cysts arising from tears of the psoterior horn of the medial meniscus: MR imaging features that simulate posterior cruciate ganglion cysts. AJR 172:1575-9,1999.
Lindgren PG, Rauschning W: Clinical and artrhographic studies on the valve mechanism in communicating popliteal cysts. Arch Orthop Traum Surg 95:245-50,1979.
Lindgren PG, Willén R: Gastrocnemio-semimembranous bursa and its relation to the knee joint. I. Anatomy and histology. Acta Radiol 18:497-512,1977.
Lindgren PG, Willén R: Gastrocnemio-semimembranous bursa and its relation to the knee joint. II. Post mortem radiography. Acta Radiol 18:698-704,1977.
Lippe CN, Suprock MD: Bilateral medial meniscal cysts in a 15-year-old girl. Am J Orthop 34:195-7,2005.
Liu SS, Williams KD, Diayer BP, Spetzler RF, Sonntag VK: Synovial cysts of the lumbosacral spine: diagnosis by MR imaging. AJR 154:163-6,1990.
Magee T, Hinson G: Association of paralabral cysts with acetabular disorders. AJR 174:1381-4,2000.
Magee TH, Rowedder AM, Degnan GG: Intraosseous ganglia of the wrist. Radiology 195:517-20,1995.
Malghem J, Vandeberg B, Lebon C, Lecouvet F, Madague B: Ganglion cysts of the knee: articular communication revealed by delayed radiography and CT after arthrography. AJR 170:1579-83,1998.
Mass DP, Tortosa R, Newmeyer WL, Kilgore ES: Compression of posterior interosseous nerve by a ganglion--case report. J Hand Surg 7:92-4,1982.
Matthews P: Ganglia of the flexor sheaths in the hand. JBJS 55A:612-7,1973.
Maw A, Renaut AJ: Pseudoaneurysm of the radial artery complicating excision of a wrist ganglion. J Hand Surg 21B:783-4,1996.
McCollam SM, Corley FG, Green DP: Posterior interosseous nerve palsy caused by ganglions of the proximal radioulnar joint. J Hand Surg 13A:725-8,1988.
Miller TT, Staron RB, Koenigsberg T, Levin TL, Feldman F: MR imaging of Baker Cysts: association with internal derangement, effusion, and degenerative arthropathy. Radiology 201:247-50,1996.
Mills CA, Henderson IJP: Cysts of the medial meniscus. Arthroscopic diagnosis and management. J Bone Joint Surg 75B:293-8, 1993.
Nagaoka M, Satou K: Tarsal tunnel syndrome caused by ganglia. J Bone Joint Surg 81B:607-10,1999.
Nakamichi K, Tachibana S: Intraneural ganglion of the brachial plexus. J Hand Surg 23B:123-5,1998.
Niedl DV, Evans DM: Aspiration of ganglia. J Hand Surg 11B:264,1986.
Ogino T, Minami A, Fukada K, Sakuma T, Kato H: The dorsal occult ganglion of the wrist and ultrasonography: J Hand Surg 13B:181-3,1988.
Ogino T, Minami A, Kato H: Diagnosis of radial nerve palsy caused by ganglion with use of different imaging techniques. J Hand Surg 16A:230-5,1991.
Ogino T, Minami A, Kato H, Hara R, Susuki K: Entrapment neuropathy of the suprascapular nerve by a ganglion. J Bone Joint Surg 73A:141-7,1991.
Østergaard M, Court-Payen M, Gideon P, : Ultrasonography in arthritis of the knee: a comparison with MR imaging. Acta Radiol 36:19-26,1995.
Paley D, Lloyd GJ: Ganglion of the ulnar groove with ulnar nerve compression. Orhtopaedic Review 14:91-3,1985.
Pannunzio M, Dorf E, Chhabra B: Multiple ganglion cyst formation of a flexor tendon after surgical release of a trigger finger. Am J Orthop 35:237-9,2006.
Parisien JS: Arthroscopic treatment of cysts of the menisci: a preliminary report. Clin Orthop 257:154-8,1990.
Parlier-Cuau C, Wyber M, Nizard R, Champsaur P, Le Hir P, Laredo JD: Symptomatic lumbar facet joint synovial cysts: clinical assessment of facet joint steroid injection after 1 and 6 months and long-term follow-up in 30 patients. Radiolgoy 210:509-13,1999.
Passler jM, Hofer HP, Peicha G, Wildburger R: Arthroscopic treatment of meniscal cysts. J Bone Joint Surg 75B:293-8,1993.
Paul AS, Sochart DH: Improving the results of ganglion aspiration by the use of hyaluronidase. J Hand Surg 22B:219-21,1997.
Rauschning W: Popliteal cysts and their relation to the gastrocnemio-semimembranous bursa: studies on the surgical and functional anatomy. Acta Orthop Scand 179:9-43,1979.
Richman JA, Gelberman RH, Engber WD, Salamon PB, Bean DJ: Ganglions of the wrist and digits: results of treatment by aspiration and cyst wall puncture. J Hand Surg 12A:1041-3,1987.
Rosson JW, Walker G: The natural history of ganglia in children. J Bone Joint Surg 71B:707-8,1989.
Ryu RK, Ting AJ: Arthroscopic treatment of meniscal cysts. Arthroscopy 9:591-5,1993.
Samuelson C, Ward JR, Albo D: Rheumatoid synovial cyst of the hip. A case report. Arthritis Rheum 14:105-8,1971.
Sanders TG, Tirman PFJ: Paralabral cyst: an unusual cause of quadrilateral space syndrome. Arthroscopy 15:632-7,1999.
Sanders WE: The occult dorsal carpal ganglion. J Hand Surg 10B:257-60,1985.
Savage L, Garth WP, Jr: Intra-articular synovial cyst of the knee originating from a chondral fracture of the medial femoral condyle. A case report. J Bone Joint Surg 76A:1394-6, 1994.
Scapinelli R: A synovial ganglion of the popliteus tendon simulating a parameniscal cyst. Two case reports. J Bone Joint Surg 70A:1085-6, 1988.
Schnarkowski P, Stinbach LS, Tirman PF, Peterfy CG, Benant HK: Magnetic resonance imaging of labral cysts of the hip. Skeletal Radiol 25:733-7,1996.
Scranton JR, Farrar EL: Mucoid degeneration of the patellar ligament in athletes. J Bone Joint Surg 74A:435-7,1992.
Seidman GD, Margles SW: Dorsal wrist ganglion presenting as anterior wrist ganglion. J Hand Surg 19A:959-60,1994.
Seidman GD, Margles SW: Intratendinous ganglia of the hand. J Hand Surg 18:707-10,1993.
Seger BM, Woods GW: Arthroscopic management of lateral meniscal cysts. Am J Sports Med 14:105-8,1986.
Sevilla CA: Ganglion of the anterior cruciate ligament presented as a knee mass. Am J Orthop 25:46-8,1996.
Sherman PM, Matchette MW, Sander TG, Parsons TW: Acetabular paralabral cyst: an uncommon cause of sciatica. Skeletal Radiol 32:90-4,2003.
Shigeno Y. Harada I, Katayama S: Treatment of cystic lesions of soft tissue using fibrin sealant. Clin Orthop 321:239-44, 1996.
Steiger R, Vögelin E: Compression of the radial nerve caused by an occult ganglion. Three case reports. J Hand Surg 23B:420-1,1998.
Steiner E, Steinbach LS, Schnarkowski P, Tirman PF, Genant HK; Ganglia and cysts around joints. Radiol Clin North Am 34:395-425, xi-xii, 1996.
Stone KR, Stoller D, De Carli A, Day R, Richnak J: The frequency of Baker's cysts associated with medial tears. Am J Sports Med 24:670-1,1996.
Summers RM, Quint DJ: Case report 712: hemorrhagic synovial cyst arising from right L2-L3 facet joint. Skeletal Rakiol 21:72-5,1992.
Takakura Y, Kumai T, Takaoka T, Tamai S: Tarsal tunnel syndrome caused by coalition associated with a ganglion. J Bone Joint Surg 80B:130-3,1998.
Tashjian RZ, Nickisch F, Dennison D: Ruptured septic popliteal cyst assocated with psoriatic arthritis. Orthopedics 27:231-3,2004.
Tehranzadeh J, Anavim A, Lin F: Radiographically ossified ganglion cyst of finger in a swimmer. Skeletal Radiol 27:705-7,1998.
Thornburg LE: Ganglions of the hand and wrist. J Am Acad Orthop Surg 7:231-8, 1999.
Tirman P, Feller J, Janzen D, Peterfy C, Bergman A: Association of glenoid labral cysts with labral tears and glenohumeral instability: radiologic findings and clinical significance. Radiology 190:653-8,1994.
Tung GA, Entzian D, Stern JB, Green A: MR imaging and MR arthrography of paraglenoid labral cysts. AJR 174:1707-15,2000.
Tyson LL, Daughters TC, Ryu RK, Crues JV, 3rd: MRI appearance of meniscal cysts. Skeletal Radiol 24:421-4,1995.
Van Geertruyden JP, Vandeweyer E: A palmer ganglion arising from the metacarpophalangeal joint. J Hand Surg 23B:428,1998.
Van Mourik JBA, Josaputra HA, Axler A: Giant synovial cyst causing deep venous thrombosis: brief report. J Bone Joint Surg 70B:841,1988.
Varley GW, Needoff M, Davis TRC, Clay NR: Conservative management of wrist ganglioa. J Hand Surg 22B:636-7,1997.
Ward EE, Jacobson JA, Fessell DP, Hayes CW, van Holsbeeck M: Sonographic detection of Baker's cysts: comparison with MR imaging. AJR 176:373-80,2001.
Ward WG, Eckardt JJ: Ganglion cyst of the proximal tibiofibular joint causing anterior compartment syndrome. A case report and anatomical study. J Bone Joint Surg 76A:1561-4, 1994.
Watson MD, Kaye JJ: Traumatic venous aneurysm presenting as a ganglion cyst. A case report. J. Bone Joint Surg. 70-A:1248-50, 1988.
Watson HK, Rogers WD, Ashmead D, IV: Reevaluation of the cause of the wrist ganglion. J Hand Surg 14A:812-7,1989.
White TK, Incavo SJ, Moreland MS: Giant synovial cyst of the hip joint.Orthop Rev 17:609-12,1988.
Williams JS Jr, Abate JA, Fadale PD, Tung GA: Meniscal and nonosseous ACL injuries in children and adolescents. Am J Knee Surg 9:22-6,1996.
Wright TW, Cooney WP, Ilstrup DM: Anterior wrist ganglion. J Hand Surg 19:954-8,1994.
Yasuda K, Majima T: Intra-articular ganglion blocking extension of the knee: brief report. J Bone Joint Surg 70B:837,1988.
Young SC, Freiberg A: A case of intratendinous ganglion. J Hand Surg 10:723-4,1985.
Zubowicz VN, Ishii CH: Management of ganglion cysts of the hand by simple aspiration. J Hand Surg 12A:618-20,1987.