Ganglión en el túnel del tarso: ¿localización intra o extraneural?

Abstract

Intraneural ganglion cysts are very uncommon lesions that are starting to be diagnosed thanks to the establishment of the articular theory to explain their pathogenesis and to the definition of their signs on magnetic resonance imaging (MRI). We present the case of a 59-year-old man with clinical findings suggestive of tarsal tunnel syndrome. MRI of the ankle and foot showed an intraneural ganglion cyst involving the posterior tibial nerve and its connection with the subtalar joint through an articular nerve branch. The appropriate interpretation of specific radiologic signs such as the “signet ring sign” enabled an appropriate preoperative diagnosis to be established, differentiating it from an extraneural lesion and facilitating the articular disconnection of the nerve branch during surgery.