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Medical Science Monitor Basic Research


A Unique Technique for Precise Targeting in Treatment of Rare Bifocal Intraosseous Ganglion Cysts of the Talus: A Case Report and Review of the Literature

Challenging differential diagnosis, Rare disease

Antonios Kouzelis, Irini Tatani, Andreas Panagopoulos, Eleftheria Antoniadou, Aikaterini Solomou, Dimitra Koumoundourou, Zinon T. Kokkalis, Vasileios Athanasiou, Georgios M. Diamantakis, Evangelia Mendrinou

Greece Department of Orthopaedic Surgery, General University Hospital of Patras, Patras, Greece

Am J Case Rep 2021; 22:e932261

DOI: 10.12659/AJCR.932261

Available online: 2021-06-11

Published: 2021-07-20


BACKGROUND: This article presents a rare case of 2 separate intraosseous ganglion cysts of the talus in a 51-year-old man, treated with a unique technique of precise lesion targeting to avoid extensive bone loss and minimize articular chondral injury of the talus.
CASE REPORT: Two separate intraosseous ganglion cysts of the talus were diagnosed in a 51-year-old man with chronic ankle pain. A single straight-line incision with an entry point through the talonavicular joint was created to spare the precarious blood supply of the talus network. The 2 distinct subchondral lesions were approached under fluoroscopic control for curettage and autologous bone grafting using the anterior cruciate ligament tibial guide in a pair-of-compasses fashion. In almost 5 years of follow-up the patient has been asymptomatic. Magnetic resonance imaging has revealed no signs of degenerative changes in the ankle or the talonavicular joint, and the intraosseous edema has almost disappeared.
CONCLUSIONS: To the best of our knowledge, this case is the first report of 2 distinct intraosseous ganglion cysts of the talus. We recommend the precise targeting technique used in our case for treating intraosseous talar lesions with intact articular cartilage.

Keywords: Bone Cysts, Ganglion Cysts, Histological Techniques, Teaching, Talus, Teaching, Adult