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Common Peroneal Nerve Ganglion Cyst
 

Author: Kyle Samyn, DO, MS
Affiliation: Ascension Providence Sports Medicine Fellowship
Co Author(s): Nicholas Moore, MD
Senior Editor: Laura Mattson, DO

Clinical Vignette: A 59-year-old male presented with left lower leg pain at the proximal fibula. The pain started insidiously roughly a year prior and gradually worsened over that time. The pain radiated down the lateral leg to just above the lateral malleolus. Pain worsened with applied pressure/contact to the proximal fibula and was described as "sharp." The pain had been keeping him from walking or exercising for a period of 2 weeks. Pain severity was rated a 10/10. The patient denied weakness in dorsiflexion of the left foot On examination, there was no weakness of ankle dorsiflexion or great toe extension. Neither restriction of lumbosacral range of motion nor complaints of low back pain was observed. Although tenderness without swelling was present around the left fibular head, Tinel's sign was not evoked along the course of the peroneal nerve. There was no pain, spontaneously or evoked, in association with the passive movement of the knee or ankle. There was no abnormality in sensory examinations. Sciatic root stretch signs were negative.

Type of Probe Used: 15-6 MHz linear array transducer



Unlabeled Long Axis View of the Left Common Peroneal Nerve at the Fibular Neck


Labeled Long Axis View of the Left Common Peroneal Nerve at the Fibular Neck with a hypoechoic intraneural ganglion cyst disrupting the normal striated pattern of the nerve.


Unlabeled Short Axis View of the Left Common Peroneal Nerve at the Fibular Neck


Labeled Short Axis View of the Left Common Peroneal Nerve at the Fibular Neck with evidence of a hypoechoic intraneural ganglion cyst


Unlabeled Long Axis Comparison View of the Bilateral Common Peroneal Nerves at the Fibular Neck.


Labeled Long Axis Comparison View of the Bilateral Common Peroneal Nerves at the Fibular Neck. The left (symptomatic) side demonstrates hypoechoic intraneural ganglion cyst disrupting the normal striated pattern of the nerve. Comparison views of the right, normal appearing common peroneal nerve of uniform thickness and showing internal striations due to the interface between the perineurium and the individual fascicles that comprise the nerve.

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