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.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Hogh J (1988) Benign cystic lesions of peripheral nerves. Int Orthop 12:269–271
Spinner RJ, Amrami KK, Elshiekh MAI, Blitz NM (2012) Sural intraneural ganglion cysts are joint-related. Arch Plast Surg 39:77–79. https://doi.org/10.5999/aps.2012.39.1.77A
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. https://doi.org/10.1053/j.jfas.2008.01.002
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
Ortiguela ME, Wood MB, Cahill DR (1987) Anatomy of the sural nerve complex. J Hand Surg Am 12:1119–1123. https://doi.org/10.1016/S0363-5023(87)80129-6
Hirose CB, Mcgarvey WC (2004) Peripheral nerve entrapments. Foot Ankle Clin N Am 9:255–269. https://doi.org/10.1016/j.fcl.2004.02.001
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. https://doi.org/10.1016/S0003-9993(99)90206-X
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
Donovan A, Rosenberg ZS, Cavalcanti CF (2010) MR imaging of entrapment neuropathies of the lower extremity. Radiographics 30:1001–1019. https://doi.org/10.1148/rg.304095188
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
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
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. https://doi.org/10.1155/2012/230679
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. https://doi.org/10.1177/1071100716628915
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. https://doi.org/10.4329/wjr.v9.i5.230
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
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. https://doi.org/10.7863/jum.19220.127.116.11
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. https://doi.org/10.1007/s40477-019-00376-3
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. https://doi.org/10.1002/jcu.22561
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. https://doi.org/10.3171/2015.9.JNS141368
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. https://doi.org/10.1007/s40477-016-0211-8
Catalano O, Roldán FA, Varelli C, Bard R, Corvino A, Wortsman X (2019) Skin cancer: findings and role of high-resolution ultrasound. J Ultrasound. https://doi.org/10.1007/s40477-019-00379-0
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. https://doi.org/10.1016/j.ultrasmedbio.2016.09.008
Spinner RJ, Scheithauer BW, Amrami KK (2009) The unifying articular (synovial) origin of intraneural ganglia evolution-revelation-revolution. Neurosurgery 65:A115–A124
Spinner RJ, Atkinson JLD, Tiel RL (2003) Peroneal intraneural ganglia: the importance of the articular branch. A unifying theory. J Neurosurg 99:330–343. https://doi.org/10.3171/jns.2003.99.2.0330
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures in studies involving human participants were in accordance with ethical standard of the institutional and /or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
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). https://doi.org/10.1007/s40477-019-00387-0