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Sciatic cross-over in patients with peroneal and tibial intraneural ganglia confirmed by knee MR arthrography.
Acta Neurochir (Wien). 2009 Jan; 151(1):89-98.AN

Abstract

BACKGROUND

A predictable mechanism and stereotypic patterns of peroneal intraneural ganglia are being defined based on careful analysis of MRIs. Peroneal and tibial intraneural ganglia extending from the superior tibiofibular joint which extend to the level of the sciatic nerve have been observed leading to the hypothesis that sciatic cross-over could exist. Such a cross-over phenomenon would allow intraneural cyst from the peroneal nerve by means of its shared epineurial sheath within the sciatic nerve to cross over to involve the tibial nerve, or vice versa from a tibial intraneural cyst to the peroneal nerve.

METHOD AND FINDINGS

One patient with a peroneal intraneural ganglion and another with a tibial intraneural ganglion each underwent a knee MR arthrogram. These studies were not only definitive in demonstrating the communication of the cyst to the superior tibiofibular joint connection but also in confirming sciatic cross-over. Contrast injected into the knee could be demonstrated tracking to the superior tibiofibular joint and then proximally into the common peroneal or tibial nerve respectively, crossing over at the sciatic nerve, and then descending down the tibial and peroneal nerves. The arthrographic findings mirrored MR images upon their retrospective review.

CONCLUSIONS

This study provides direct in vivo proof of the nature of sciatic cross-over theorized by critical review of MRIs and/or experimental dye injections done in cadavers. This study is important in clarifying the potential paths of propagation of intraneural cysts at points of major bifurcation.

Authors+Show Affiliations

Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55905, USA. spinner.robert@mayo.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

19148568

Citation

Spinner, Robert J., et al. "Sciatic Cross-over in Patients With Peroneal and Tibial Intraneural Ganglia Confirmed By Knee MR Arthrography." Acta Neurochirurgica, vol. 151, no. 1, 2009, pp. 89-98.
Spinner RJ, Wang H, Hébert-Blouin MN, et al. Sciatic cross-over in patients with peroneal and tibial intraneural ganglia confirmed by knee MR arthrography. Acta Neurochir (Wien). 2009;151(1):89-98.
Spinner, R. J., Wang, H., Hébert-Blouin, M. N., Skinner, J. A., & Amrami, K. K. (2009). Sciatic cross-over in patients with peroneal and tibial intraneural ganglia confirmed by knee MR arthrography. Acta Neurochirurgica, 151(1), 89-98. https://doi.org/10.1007/s00701-008-0182-4
Spinner RJ, et al. Sciatic Cross-over in Patients With Peroneal and Tibial Intraneural Ganglia Confirmed By Knee MR Arthrography. Acta Neurochir (Wien). 2009;151(1):89-98. PubMed PMID: 19148568.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sciatic cross-over in patients with peroneal and tibial intraneural ganglia confirmed by knee MR arthrography. AU - Spinner,Robert J, AU - Wang,Huan, AU - Hébert-Blouin,Marie-Noëlle, AU - Skinner,John A, AU - Amrami,Kimberly K, Y1 - 2009/01/16/ PY - 2008/07/16/received PY - 2008/11/20/accepted PY - 2009/1/17/entrez PY - 2009/1/17/pubmed PY - 2009/4/10/medline SP - 89 EP - 98 JF - Acta neurochirurgica JO - Acta Neurochir (Wien) VL - 151 IS - 1 N2 - BACKGROUND: A predictable mechanism and stereotypic patterns of peroneal intraneural ganglia are being defined based on careful analysis of MRIs. Peroneal and tibial intraneural ganglia extending from the superior tibiofibular joint which extend to the level of the sciatic nerve have been observed leading to the hypothesis that sciatic cross-over could exist. Such a cross-over phenomenon would allow intraneural cyst from the peroneal nerve by means of its shared epineurial sheath within the sciatic nerve to cross over to involve the tibial nerve, or vice versa from a tibial intraneural cyst to the peroneal nerve. METHOD AND FINDINGS: One patient with a peroneal intraneural ganglion and another with a tibial intraneural ganglion each underwent a knee MR arthrogram. These studies were not only definitive in demonstrating the communication of the cyst to the superior tibiofibular joint connection but also in confirming sciatic cross-over. Contrast injected into the knee could be demonstrated tracking to the superior tibiofibular joint and then proximally into the common peroneal or tibial nerve respectively, crossing over at the sciatic nerve, and then descending down the tibial and peroneal nerves. The arthrographic findings mirrored MR images upon their retrospective review. CONCLUSIONS: This study provides direct in vivo proof of the nature of sciatic cross-over theorized by critical review of MRIs and/or experimental dye injections done in cadavers. This study is important in clarifying the potential paths of propagation of intraneural cysts at points of major bifurcation. SN - 0942-0940 UR - https://www.unboundmedicine.com/medline/citation/19148568/Sciatic_cross_over_in_patients_with_peroneal_and_tibial_intraneural_ganglia_confirmed_by_knee_MR_arthrography_ L2 - https://dx.doi.org/10.1007/s00701-008-0182-4 DB - PRIME DP - Unbound Medicine ER -