گانگلیون داخل استخوانی اسکافوئید ( گزارش یک مورد و مروری بر مقالات پزشکی)

Although soft tissue ganglia are commonly encountered, their intraosseous counterparts have been rarely recorded. This apparent rarity may be due to confusion in terminology or asymptomatic lesions. The intra osseous ganglion is grossly and histologically identical to soft tissue ganglion and has the same pathogenesis. The patient has mild pain during activity or may be asymptomatic. Lab tests normal. These lesions present a characteristic lytic roentgenographic appearance with sclerotic rim and are most often seen eccentrically at the end of a long bone, frequently the lower end of the tibia, in middle aged patients. Bone scan demonstrates increased uptake. There are two types of lesions: one apparently arising from penetration of soft tissue ganglion into the underlying bone, and the other is an idiopathic from which is primarily intra osseous. Although the pathogenesis is still uncertain, current opinion tends to support the theory of intramedullay metaplasia and proliferation of fibroblastic elements (fibroplasia): The mechanical stress and repeated minor trauma near the surface of the bone may lead to intramedullary vascular disturbance with consequent foci of aseptic bone necrosis. The revitalisation of these areas causes fibroblastic proliferation, followed by a degenerative stage with mucoid secretion and accumulation which enlarges the ganglionic cyst. Curretage (With or without bone graft) or excision is usually effective, and recurrence is rare. The purpose of this paper is to describe a case of an intraosseous ganglion occurring within the scaphoid bone, and review of the literature.