THE CYSTIC TRANSVERSE LIMB OF THE ARTICULAR BRANCH
Notice bibliographique
Résumé
OBJECTIVE The preoperative diagnosis of peroneal intraneural ganglia has been difficult to establish and superior tibiofibular joint connections may not be identified. Misdiagnosis leads to incomplete treatment in that the articular branch connection may not be addressed which can result in cyst recurrences. METHODS We analyzed 20 surgically confirmed cases of paraarticular cysts arising from the superior tibiofibular joint to assess for joint connections and to determine common MRI characteristics in intraneural ganglia that would allow distinction from extraneural ganglia. We identified and tested 3 radiographic signs describing the cysts and analyzed cyst morphology (i.e, size, shape, pattern), muscle compartments affected (i.e., for denervation) and neighboring joints (for associated pathology). RESULTS Twelve cases of peroneal intraneural ganglia and 8 cases of extraneural ganglia were connected to the superior tibiofibular joint. Retrospective review confirmed that these cysts were frequently misdiagnosed and joint connections were often not recognized. The MR appearance of peroneal intraneural ganglia was stereotypic. These intraneural ganglia were tubular whereas the extraneural were more mass-like. The tail sign was 100% sensitive for identifying joint connections but could not distinguish between intra and extraneural cysts. The “transverse limb” sign [cystic material within the portion of the articular branch traversing the anterior surface of the fibula] was present in all cases of peroneal intraneural ganglia and none of the extraneural ganglia. The signet ring sign [the eccentric displacement of fascicles by cyst within the epineurium] was 100% sensitive for peroneal intraneural ganglia and 86% specific (it did not identify 2 cysts that did not extend more proximally into the common peroneal nerve). There was 100% interobserver concordance between the prospective interpretations by a blinded single radiologist and a trained first year medical student with intraoperative findings. In this series, muscle denervation was more common and more pronounced in the intraneural than extraneural ganglia. Abnormalities in neighboring joints were noted nearly universally. CONCLUSION This paper demonstrates reproducible MRI features which will easily allow one to identify the joint connection (the tail sign) in para-articular cysts and also to distinguish between peroneal intraneural and extraneural ganglia (the transverse limb sign and the signet ring sign) at the superior tibiofibular joint with accuracy and confidence with subsequent improvement in treatment and patient outcomes.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».