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2017 | 17 | 68 | 73–75
Article title

Posterior interosseous nerve palsy caused by a ganglion: Conservative treatment with ultrasound-guided needle aspiration

Title variants
Porażenie nerwu międzykostnego tylnego spowodowane obecnością ganglionu: leczenie zachowawcze – aspiracja pod kontrolą ultrasonografii
Languages of publication
Posterior interosseous nerve palsy caused by a ganglion is not common and most previous patients were treated with excisional surgery. We treated a case conservatively with needle aspiration using ultrasonography, after a nerve conduction study. A 77-year-old man presented with impaired active finger extension of the left metacarpophalangeal joints. The nerve conduction study revealed conduction block of the left radial nerve near the elbow. Ultrasonography demonstrated a hypoechoic mass anterior to the radial neck compressing the posterior interosseous nerve. Then, needle aspiration of the mass was conducted under ultrasonography. Two months later, active finger extension recovered to normal. A ganglion can be diagnosed with ultrasonography and needle aspiration can be carried out safely under ultrasonography. A nerve conduction study can assess the degree of nerve damage. The combination of ultrasonography and a nerve conduction study can facilitate conservative treatment of needle aspiration for posterior interosseous nerve palsy caused by a ganglion.
Porażenie nerwu międzykostnego tylnego spowodowane obecnością ganglionu nie jest zjawiskiem powszechnym. Po raz pierwszy zostało opisane przez Bowena(1). Większość wcześniejszych przypadków leczono przy pomocy wycięcia chirurgicznego. U naszego pacjenta potwierdziliśmy rozpoznanie i określiliśmy lokalizację ucisku nerwu w badaniu elektromiograficznym. Pacjent został skierowany na leczenie zachowawcze metodą aspiracji igłowej pod kontrolą ultrasonografii (USG). Artykuł w wersji polskojęzycznej jest dostępny na stronie

Physical description
  • Department of Orthopedic Surgery, Suwa Central Hospital, Chino, Japan,
  • 1. Bowen TL, Stone KH: Posterior interosseous nerve paralysis caused by a ganglion at the elbow. J Bone Joint Surg Br 1966; 48: 774–776.
  • 2. Jou IM, Wang HN, Wang PH, Yong IS, Su WR: Compression of the radial nerve at the elbow by a ganglion: two case reports. J Med Case Rep 2009; 3: 7258.
  • 3. Khan PS, Hayat H: Surgical excision versus aspiration combined with intralesional triamcinolone acetonide injection plus wrist immobilization therapy in the treatment of dorsal wrist ganglion; a randomized controlled trial. J Hand Microsurg 2011; 3: 55–57.
  • 4. Latif A, Ansar A, Butt MQ: Treatment of ganglions; a five year experience. J Pak Med Assoc 2014; 64: 1278-1281.
  • 5. Joint Task Force of the EFNS and the PNS: European Federation of Neurological Societies/Peripheral Nerve Society guideline on management of multifocal motor neuropathy. Report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society-first revision. J Peripher Nerv Syst 2010; 15: 295–301.
  • 6. Seddon HJ: A classification of nerve injuries. Br Med J 1942; 2: 237–239.
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