空気肩関節造影検査後，棘窩切痕部ガングリオン内に空気が貯留した一例

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  • A case of the air presented in ganglion cyst after air shoulder arthrography

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Cases of spinoglenoid notch ganglion causing suprascapular nerve palsy have been well documented. Because labral tears were confirmed arthroscopically in all patients on whom we performed arthroscopic decompression in our institution, we think that the one way valve mechanism causes ganglion cysts. In this study, we describe a case suggesting the air broke into the ganglion cyst through the torn labrum by air arthrography. A 23-year-old female presented to our institution with right shoulder pain. Physical examination revealed no limited ROMs, less muscle strength of external rotation, and O'Brien's test and crank test were positive. Magnetic resonance imaging (MRI) demonstrated large multilocular cysts in which T1 weighted-imaging was low and T2 weighted-imaging was high from supraspinous fossa to infraspinous fossa. Computed tomography (CT) and MRI after air arthrography showed the presence of air in the ganglion cyst and between the glenoid and the superior posterior labral. Arthroscopic evaluation confirmed type 2 SLAP lesion extending from the 10:00 to the 12:30 position.<BR>The ganglion cysts were approached between the glenoid and detached labrum. An amber-colored fluid and air were evacuated when the cystic capsule was incised. The cystic capsules were excised and the superior labrum was repaired.<BR>Six months follow-up demonstrated complete relief of pain. MRI showed disappearance of the cysts, and no recurrences.<BR>In general, it is said that the ganglion cyst is formed by extra-articular mucin droplets coalescing from intra-articular synovial fluid. This case suggested that the detached labrum functioned as a check-valve from articular joint into the ganglion cyst.

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  • 肩関節

    肩関節 36 (3), 1083-1085, 2012

    日本肩関節学会

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