Roberto Prost MD, Presenter: Nothing to Disclose

Jenny T. Bencardino MD, Abstract Co-Author: Nothing to Disclose

Zehava Sadka Rosenberg MD, Abstract Co-Author: Nothing to Disclose

To describe the MRI features of a rarely reported intratendinous ganglion cyst (ITG).

1. Definition: Intratendinous ganglion (ITG) is often associated with extensive longitudinal split tendon tears.  2. Pathophysiolgy: The mechanism for forming ITG remains unclear but may reflect focal fluid accumulation, via a ball valve effect, in extensively degenerated tendons. 3. Location: Can affect any severely torn tendon. Based on retrospective review of our database we noted ITG to be in the following locations: rotator cuff (5), biceps tendon (5); patellar tendon (5), semimembranosus tendon (1); peroneus brevis tendon (6), peroneus longus tendon (1), Achilles tendon (1), extensor digitorum communis (3).  4. MRI appearance: ITG is confined to the tendon substance and has well-defined fluid-like signal on T1 and T2W images with thin rim enhancement post intravenous contrast.  5. Differential diagnosis: mucoid degenerative tendinopathy, loculated tenosynovitis and tendon tear. 6. Clinical significance: remains unclear but ITG may need to be resected due to increased pressure and pain.   

ITG are rare lesions, confined by the tendon sheath or paratenon.  MRI allows delineation of ITG and provides excellent characterization of their location, potentially influencing treatment strategy and surgical planning.  

Prost, R, Bencardino, J, Rosenberg, Z, Intratendinous Ganglion Cyst: Depiction on MR Images.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12025422.html