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Intra-neural ganglion cyst of the lateral dorsal cutaneous nerve: an uncommon cause of lateral ankle pain



An intra-neural ganglion cyst of the lateral dorsal cutaneous branch of the sural nerve is rare, with only a few cases reported in the literature.

Materials and Methods

We carried out a retrospective investigation of patients with an intraneural ganglion cyst of the lateral dorsal cutaneous nerve.


We present a case series of four patients with intra-neural ganglion cysts of the lateral dorsal cutaneous nerve, the distal continuation of the sural nerve at the lateral aspect of the foot.


Intra-neural ganglion cysts of the lateral dorsal cutaneous nerve are rare. They represent a relatively uncommon source of lateral ankle pain, which can easily be diagnosed with ultrasound (US) and magnetic resonance imaging and managed effectively with US-guided aspiration or surgical excision.

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  1. 1.

    Hogh J (1988) Benign cystic lesions of peripheral nerves. Int Orthop 12:269–271

  2. 2.

    Spinner RJ, Amrami KK, Elshiekh MAI, Blitz NM (2012) Sural intraneural ganglion cysts are joint-related. Arch Plast Surg 39:77–79.

  3. 3.

    Blitz NM, Prestridge J, Amrami KK, Spinner RJ (2008) A posttraumatic, joint-connected sural intraneural ganglion cyst—with a new mechanism of intraneural recurrence: a case report. J Foot Ankle Surg 47:199–205.

  4. 4.

    Ogose A, Hotta T, Kawashima H, Yamagiwa H, Endo N, Umezu H (2014) Teaching neuro images: recurrence of a sural intraneural ganglion cyst after sural nerve resection. Neurology 83:95–97

  5. 5.

    Ortiguela ME, Wood MB, Cahill DR (1987) Anatomy of the sural nerve complex. J Hand Surg Am 12:1119–1123.

  6. 6.

    Hirose CB, Mcgarvey WC (2004) Peripheral nerve entrapments. Foot Ankle Clin N Am 9:255–269.

  7. 7.

    Bryan BM, Lutz GE, O’Brien SJ (1999) Sural nerve entrapment after injury to the gastrocnemius: a case report. Arch Phys Med Rehabil 80:604–606.

  8. 8.

    Lawrence SJ, Botte MJ (1994) The sural nerve in the foot and ankle: an anatomic study with clinical and surgical implications. Foot Ankle Int 15:490–494

  9. 9.

    Donovan A, Rosenberg ZS, Cavalcanti CF (2010) MR imaging of entrapment neuropathies of the lower extremity. Radiographics 30:1001–1019.

  10. 10.

    Asli ZA, Ucerler H, Bilge O (2005) The anatomic features of the sural nerve with an emphasis on its clinical importance. Foot Ankle Int 26:560–567

  11. 11.

    Webb J, Moorjani N, Chb MB, Radford M (2000) Anatomy of the sural nerve and its relation to the Achilles Tendon. Foot Ankle Int 21:475–477

  12. 12.

    Dong Q, Jacobson JA, Jamadar DA et al (2012) Entrapment neuropathies in the upper and lower limbs: anatomy and MRI features. Radiol Res Pract 2012:1–12.

  13. 13.

    Macmahon A, Deland JT, Do H et al (2016) MRI evaluation of achilles tendon rotation and sural nerve anatomy: implications for percutaneous and limited-open achilles tendon repair. Foot Ankle Int 37:636–643.

  14. 14.

    Panwar J, Mathew A, Thomas BP (2017) Cystic lesions of peripheral nerves: are we missing the diagnosis of the intraneural ganglion cyst? World J Radiol 9:230.

  15. 15.

    Vidoni A, Sankara STV, Ramana V, Botchu R (2018) Ganglion cyst arising from the transverse acetabular ligament (TAL): a rare cause of entrapment of the anterior branch of the obturator nerve. Case report and review of the literature. Skelet Radiol. 48(1):163–165

  16. 16.

    Giovagnorio F, Andreoli C, De Cicco ML (1999) Color Doppler sonography of focal lesions of the skin and subcutaneous tissue. J Ultrasound Med 18:89–93.

  17. 17.

    Corvino A, Sandomenico F, Corvino F et al (2019) Utility of a gel stand-off pad in the detection of Doppler signal on focal nodular lesions of the skin. J Ultrasound.

  18. 18.

    Shah A, Vidoni A, McGarry S, Davies M, James S, Botchu R (2018) Ethyl chloride spray for musculoskeletal ultrasound-guided injections: an alternative to subcutaneous injection of local anesthetic solution. J Clin Ultrasound 46:129–131.

  19. 19.

    Desy NM, Wang H, Elshiekh MAI et al (2016) Intraneural ganglion cysts: a systematic review and reinterpretation of the world’s literature. J Neurosurg 125:615–630.

  20. 20.

    Corvino A, Catalano O, Corvino F, Sandomenico F, Setola SV, Petrillo A (2016) Superficial temporal artery pseudoaneurysm: what is the role of ultrasound? J Ultrasound 19:197–201.

  21. 21.

    Catalano O, Roldán FA, Varelli C, Bard R, Corvino A, Wortsman X (2019) Skin cancer: findings and role of high-resolution ultrasound. J Ultrasound.

  22. 22.

    Corvino A, Corvino F, Catalano O, Sandomenico F, Petrillo A (2017) The tail and the string sign: new sonographic features of subcutaneous melanoma metastasis. Ultrasound Med Biol 43:370–374.

  23. 23.

    Spinner RJ, Scheithauer BW, Amrami KK (2009) The unifying articular (synovial) origin of intraneural ganglia evolution-revelation-revolution. Neurosurgery 65:A115–A124

  24. 24.

    Spinner RJ, Atkinson JLD, Tiel RL (2003) Peroneal intraneural ganglia: the importance of the articular branch. A unifying theory. J Neurosurg 99:330–343.

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Correspondence to R. Botchu.

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Vidoni, A., McLoughlin, E., James, S.L. et al. Intra-neural ganglion cyst of the lateral dorsal cutaneous nerve: an uncommon cause of lateral ankle pain. J Ultrasound 23, 81–86 (2020).

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  • Ganglion
  • Lateral
  • Dorsal
  • Cutaneous