Peripheral neuropathy caused by joint-related cysts: a review of 17 cases
Background Clinical compression neuropathy caused by para-articular cysts is rare. Only recently, the unifying articular theory was proposed to clarify its true etiologic nature. The authors attribute 17 cases to this theory in order to illustrate the shift in the diagnostic and treatment protocol,...
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| Veröffentlicht in: | Acta neurochirurgica 2012-10, Vol.154 (10), p.1741-1753 |
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| container_title | Acta neurochirurgica |
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| creator | Weyns, F. Bringmans, T. Vandevenne, J. Daenekindt, T. Van Goethem, A. Wuyts, J. Vanormelingen, L. Vandersteen, M. |
| description | Background
Clinical compression neuropathy caused by para-articular cysts is rare. Only recently, the unifying articular theory was proposed to clarify its true etiologic nature. The authors attribute 17 cases to this theory in order to illustrate the shift in the diagnostic and treatment protocol, and the possible impact on patient outcome.
Methods
Eight intraneural and nine extraneural cysts were included. The proposed diagnostic protocol includes electromyography and ultrasound, followed by magnetic resonance imaging to characterize the cyst. The proposed treatment protocol consists of (1) ligation of the pedicle connecting the cyst with the afflicted joint, (2) decompression of the nerve and, when needed and (3) disarticulation of the superior tibiofibular joint (in case of peroneal nerve involvement).
Results
Outcome was good to excellent in all patients, with recovery of sensory and motor function. Cyst recurrence was observed in three intraneural cases (18 %). Analysis of our own diagnostic protocol showed that atypical compression neuropathies should follow a strict diagnostic protocol to exclude missing the presence of a cyst. Ultrasound needs to play a crucial role, with MRI for cyst characterization and pedicle identification.
Conclusions
Retrospective proof in favor of the articular theory was found in all cases. An explanation for the cyst recurrences was formed based on the articular theory. In addition, a diagnostic and therapeutic protocol is proposed for all atypical peripheral compression neuropathies with the ultimate goal to achieve optimal patient outcome. |
| doi_str_mv | 10.1007/s00701-012-1444-8 |
| format | Article |
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Clinical compression neuropathy caused by para-articular cysts is rare. Only recently, the unifying articular theory was proposed to clarify its true etiologic nature. The authors attribute 17 cases to this theory in order to illustrate the shift in the diagnostic and treatment protocol, and the possible impact on patient outcome.
Methods
Eight intraneural and nine extraneural cysts were included. The proposed diagnostic protocol includes electromyography and ultrasound, followed by magnetic resonance imaging to characterize the cyst. The proposed treatment protocol consists of (1) ligation of the pedicle connecting the cyst with the afflicted joint, (2) decompression of the nerve and, when needed and (3) disarticulation of the superior tibiofibular joint (in case of peroneal nerve involvement).
Results
Outcome was good to excellent in all patients, with recovery of sensory and motor function. Cyst recurrence was observed in three intraneural cases (18 %). Analysis of our own diagnostic protocol showed that atypical compression neuropathies should follow a strict diagnostic protocol to exclude missing the presence of a cyst. Ultrasound needs to play a crucial role, with MRI for cyst characterization and pedicle identification.
Conclusions
Retrospective proof in favor of the articular theory was found in all cases. An explanation for the cyst recurrences was formed based on the articular theory. In addition, a diagnostic and therapeutic protocol is proposed for all atypical peripheral compression neuropathies with the ultimate goal to achieve optimal patient outcome.</description><identifier>ISSN: 0001-6268</identifier><identifier>EISSN: 0942-0940</identifier><identifier>DOI: 10.1007/s00701-012-1444-8</identifier><identifier>PMID: 22941422</identifier><language>eng</language><publisher>Vienna: Springer Vienna</publisher><subject>Adult ; Aged ; Clinical Article ; Compression ; Cysts ; Cysts - complications ; Cysts - surgery ; Decompression ; Decompression, Surgical - methods ; Electromyography - methods ; EMG ; Female ; Humans ; Interventional Radiology ; Joint Diseases - complications ; Joint Diseases - surgery ; Joints ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Minimally Invasive Surgery ; Neurology ; Neuroradiology ; Neurosurgery ; Peripheral Nervous System Diseases - diagnosis ; Peripheral Nervous System Diseases - etiology ; Peripheral Nervous System Diseases - surgery ; Peripheral neuropathy ; peroneal nerve ; Recurrence ; Retrospective Studies ; Surgical Orthopedics ; Treatment Outcome ; Ultrasound</subject><ispartof>Acta neurochirurgica, 2012-10, Vol.154 (10), p.1741-1753</ispartof><rights>Springer-Verlag 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-117f6b55203b4bb2295b11d638401268644c93a933918c7260ba56e6c8eb4b703</citedby><cites>FETCH-LOGICAL-c405t-117f6b55203b4bb2295b11d638401268644c93a933918c7260ba56e6c8eb4b703</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00701-012-1444-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00701-012-1444-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22941422$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Weyns, F.</creatorcontrib><creatorcontrib>Bringmans, T.</creatorcontrib><creatorcontrib>Vandevenne, J.</creatorcontrib><creatorcontrib>Daenekindt, T.</creatorcontrib><creatorcontrib>Van Goethem, A.</creatorcontrib><creatorcontrib>Wuyts, J.</creatorcontrib><creatorcontrib>Vanormelingen, L.</creatorcontrib><creatorcontrib>Vandersteen, M.</creatorcontrib><title>Peripheral neuropathy caused by joint-related cysts: a review of 17 cases</title><title>Acta neurochirurgica</title><addtitle>Acta Neurochir</addtitle><addtitle>Acta Neurochir (Wien)</addtitle><description>Background
Clinical compression neuropathy caused by para-articular cysts is rare. Only recently, the unifying articular theory was proposed to clarify its true etiologic nature. The authors attribute 17 cases to this theory in order to illustrate the shift in the diagnostic and treatment protocol, and the possible impact on patient outcome.
Methods
Eight intraneural and nine extraneural cysts were included. The proposed diagnostic protocol includes electromyography and ultrasound, followed by magnetic resonance imaging to characterize the cyst. The proposed treatment protocol consists of (1) ligation of the pedicle connecting the cyst with the afflicted joint, (2) decompression of the nerve and, when needed and (3) disarticulation of the superior tibiofibular joint (in case of peroneal nerve involvement).
Results
Outcome was good to excellent in all patients, with recovery of sensory and motor function. Cyst recurrence was observed in three intraneural cases (18 %). Analysis of our own diagnostic protocol showed that atypical compression neuropathies should follow a strict diagnostic protocol to exclude missing the presence of a cyst. Ultrasound needs to play a crucial role, with MRI for cyst characterization and pedicle identification.
Conclusions
Retrospective proof in favor of the articular theory was found in all cases. An explanation for the cyst recurrences was formed based on the articular theory. In addition, a diagnostic and therapeutic protocol is proposed for all atypical peripheral compression neuropathies with the ultimate goal to achieve optimal patient outcome.</description><subject>Adult</subject><subject>Aged</subject><subject>Clinical Article</subject><subject>Compression</subject><subject>Cysts</subject><subject>Cysts - complications</subject><subject>Cysts - surgery</subject><subject>Decompression</subject><subject>Decompression, Surgical - methods</subject><subject>Electromyography - methods</subject><subject>EMG</subject><subject>Female</subject><subject>Humans</subject><subject>Interventional Radiology</subject><subject>Joint Diseases - complications</subject><subject>Joint Diseases - surgery</subject><subject>Joints</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Minimally Invasive Surgery</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosurgery</subject><subject>Peripheral Nervous System Diseases - diagnosis</subject><subject>Peripheral Nervous System Diseases - etiology</subject><subject>Peripheral Nervous System Diseases - surgery</subject><subject>Peripheral neuropathy</subject><subject>peroneal nerve</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Surgical Orthopedics</subject><subject>Treatment Outcome</subject><subject>Ultrasound</subject><issn>0001-6268</issn><issn>0942-0940</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkU1PwzAMhiMEYmPwA7igSFy4FOIkTVtuaOJj0iQ4wLlKO5d16tqRtKD-ezx1IISEuDgffvzGzsvYKYhLECK68hQEBAJkAFrrIN5jY5FoGVAQ-7QXlDXSxCN25P2KTjLS6pCNpEw0aCnHbPaErtws0dmK19i5ZmPbZc9z23lc8Kznq6as28BhZVu6yHvf-mtuucP3Ej94U3CIiPboj9lBYSuPJ7t1wl7ubp-nD8H88X42vZkHuRZhGwBEhcnCUAqV6SyjTsIMYGFUrKk9Exut80TZRKkE4jySRmQ2NGjyGImPhJqwi0F345q3Dn2brkufY1XZGpvOpwCgpAYQ0f-o0CKhnwgVoee_0FXTuZoGIUolJjGRBqJgoHLXeO-wSDeuXFvXE5RuLUkHS1IaJd1aksZUc7ZT7rI1Lr4rvjwgQA6Ap1T9iu7n03-pfgLVtpJi</recordid><startdate>20121001</startdate><enddate>20121001</enddate><creator>Weyns, F.</creator><creator>Bringmans, T.</creator><creator>Vandevenne, J.</creator><creator>Daenekindt, T.</creator><creator>Van Goethem, A.</creator><creator>Wuyts, J.</creator><creator>Vanormelingen, L.</creator><creator>Vandersteen, M.</creator><general>Springer Vienna</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20121001</creationdate><title>Peripheral neuropathy caused by joint-related cysts: a review of 17 cases</title><author>Weyns, F. ; Bringmans, T. ; Vandevenne, J. ; Daenekindt, T. ; Van Goethem, A. ; Wuyts, J. ; Vanormelingen, L. ; Vandersteen, M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-117f6b55203b4bb2295b11d638401268644c93a933918c7260ba56e6c8eb4b703</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Clinical Article</topic><topic>Compression</topic><topic>Cysts</topic><topic>Cysts - complications</topic><topic>Cysts - surgery</topic><topic>Decompression</topic><topic>Decompression, Surgical - methods</topic><topic>Electromyography - methods</topic><topic>EMG</topic><topic>Female</topic><topic>Humans</topic><topic>Interventional Radiology</topic><topic>Joint Diseases - complications</topic><topic>Joint Diseases - surgery</topic><topic>Joints</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Minimally Invasive Surgery</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosurgery</topic><topic>Peripheral Nervous System Diseases - diagnosis</topic><topic>Peripheral Nervous System Diseases - etiology</topic><topic>Peripheral Nervous System Diseases - surgery</topic><topic>Peripheral neuropathy</topic><topic>peroneal nerve</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>Surgical Orthopedics</topic><topic>Treatment Outcome</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Weyns, F.</creatorcontrib><creatorcontrib>Bringmans, T.</creatorcontrib><creatorcontrib>Vandevenne, J.</creatorcontrib><creatorcontrib>Daenekindt, T.</creatorcontrib><creatorcontrib>Van Goethem, A.</creatorcontrib><creatorcontrib>Wuyts, J.</creatorcontrib><creatorcontrib>Vanormelingen, L.</creatorcontrib><creatorcontrib>Vandersteen, M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Acta neurochirurgica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Weyns, F.</au><au>Bringmans, T.</au><au>Vandevenne, J.</au><au>Daenekindt, T.</au><au>Van Goethem, A.</au><au>Wuyts, J.</au><au>Vanormelingen, L.</au><au>Vandersteen, M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Peripheral neuropathy caused by joint-related cysts: a review of 17 cases</atitle><jtitle>Acta neurochirurgica</jtitle><stitle>Acta Neurochir</stitle><addtitle>Acta Neurochir (Wien)</addtitle><date>2012-10-01</date><risdate>2012</risdate><volume>154</volume><issue>10</issue><spage>1741</spage><epage>1753</epage><pages>1741-1753</pages><issn>0001-6268</issn><eissn>0942-0940</eissn><abstract>Background
Clinical compression neuropathy caused by para-articular cysts is rare. Only recently, the unifying articular theory was proposed to clarify its true etiologic nature. The authors attribute 17 cases to this theory in order to illustrate the shift in the diagnostic and treatment protocol, and the possible impact on patient outcome.
Methods
Eight intraneural and nine extraneural cysts were included. The proposed diagnostic protocol includes electromyography and ultrasound, followed by magnetic resonance imaging to characterize the cyst. The proposed treatment protocol consists of (1) ligation of the pedicle connecting the cyst with the afflicted joint, (2) decompression of the nerve and, when needed and (3) disarticulation of the superior tibiofibular joint (in case of peroneal nerve involvement).
Results
Outcome was good to excellent in all patients, with recovery of sensory and motor function. Cyst recurrence was observed in three intraneural cases (18 %). Analysis of our own diagnostic protocol showed that atypical compression neuropathies should follow a strict diagnostic protocol to exclude missing the presence of a cyst. Ultrasound needs to play a crucial role, with MRI for cyst characterization and pedicle identification.
Conclusions
Retrospective proof in favor of the articular theory was found in all cases. An explanation for the cyst recurrences was formed based on the articular theory. In addition, a diagnostic and therapeutic protocol is proposed for all atypical peripheral compression neuropathies with the ultimate goal to achieve optimal patient outcome.</abstract><cop>Vienna</cop><pub>Springer Vienna</pub><pmid>22941422</pmid><doi>10.1007/s00701-012-1444-8</doi><tpages>13</tpages></addata></record> |
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| subjects | Adult Aged Clinical Article Compression Cysts Cysts - complications Cysts - surgery Decompression Decompression, Surgical - methods Electromyography - methods EMG Female Humans Interventional Radiology Joint Diseases - complications Joint Diseases - surgery Joints Magnetic resonance imaging Magnetic Resonance Imaging - methods Male Medicine Medicine & Public Health Middle Aged Minimally Invasive Surgery Neurology Neuroradiology Neurosurgery Peripheral Nervous System Diseases - diagnosis Peripheral Nervous System Diseases - etiology Peripheral Nervous System Diseases - surgery Peripheral neuropathy peroneal nerve Recurrence Retrospective Studies Surgical Orthopedics Treatment Outcome Ultrasound |
| title | Peripheral neuropathy caused by joint-related cysts: a review of 17 cases |
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