- MeSH
- bederní obratle MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- meziobratlový kloub MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- spondylolistéza diagnóza komplikace MeSH
- synoviální cysta diagnóza komplikace MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
The aim of this case report is to present an unusual double synovial cyst that arose from the proximal tibiofibular joint compressing the peroneal nerve in the peroneal tunnel and was unrecognized at the beginning. According to the review of literature back to 1891, only 62 cases of cysts originating from the proximal tibiofibular joint (PTFJ) have been described. We report a case of a 32 year old male patient who was admitted to the Department of Orthopaedic Surgery because of a classic peroneal tunnel syndrome of the left leg. On the lateral side of the proximal third of his left leg a tumefaction of 12 x 2.5 cm was visible. The sonography showed a characteristic image of the para-articular synovial cyst of the left knee. A surgical extirpation of the synovial cyst and decompression of the peroneal nerve in the peroneal tunnel were performed. PHD confirmed a classic synovial cyst. Postoperatively, the symptoms of the peroneal nerve compression disappeared. Three years after the first surgical intervention the patient was readmitted to the Department because of quite similar problems, only the neurological symptoms were less intensive than during the first admittance. This time the performed MR imaging showed a double synovial cyst originating from the proximal tibiofibular joint. The surgical treatment consisted of a total extirpation of both cysts including the narrow stalks of communication with the PTFJ. The joint was opened and a synovectomy was done using an electrocauter and a sharp curette. Regular check-ups were done every 6 months and twice during the control period of 4 years, as was the MR imaging control. MRI findings 4 years after the second surgical intervention were normal. Clinical findings after 7 years were normal and we are sure that the recidivation of the synovial cyst excluded. The MRI diagnostics was crucial for an adequate surgical treatment and the relief of the peroneal tunnel syndrome symptoms.
- MeSH
- dospělí MeSH
- fibula patologie MeSH
- kolenní kloub patologie MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- nervus peroneus MeSH
- synoviální cysta diagnóza chirurgie komplikace MeSH
- úžinové syndromy etiologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Autor shrnuje na základě aktuální rešerše v systému MEDLINE znalosti o vzácné příčině chronické lumbois-chialgie - juxtafacetálních cystách. Uvádí klinický obraz, výsledky CT, MRI, PMG a funkčních rtg snímků spolu s úplným spektrem terapeutických modalit. Doporučuje operaci jako definitivní a bezpečnou metodu léčby. Na podkladě svých limitovaných, ale dlouhodobě příznivých chirurgických zkušeností, se přiklání k pouhé dekompresivní operaci (resekci cysty z částečné hemilaminektomie). Stabilizaci postiženého segmentu (ve druhé době) rezervuje pouze pro těch několik případů, u nichž reziduální potíže mohou být jednoznačně vysvětlitelné instabilitou tohoto segmentu.
The author summarizes our knowledge of this rare cause of chronic lumbar root pain, based on a thorough research of the recent literature in MEDLINE. He gives the clinical picture, the CT, MRI and PMG findings as well as functional x-ray studies, and all the relevant therapeutic modalities. He advocates decompressive surgery on the basis of his long but limited experiences as a safe treatment giving permanent results (removal of the cyst with partial decompressive hemilaminectomy). Surgical stabilization is justified only in cases of residual complaints caused clearly by segmental instability.
- MeSH
- chirurgická dekomprese metody MeSH
- dospělí MeSH
- ischialgie diagnóza etiologie terapie MeSH
- lidé MeSH
- lumbalgie diagnóza etiologie terapie MeSH
- MEDLINE MeSH
- nemoci páteře etiologie MeSH
- ortopedické výkony metody trendy MeSH
- synoviální cysta komplikace MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
