Glenoid Subchondral Cystic Lesion -Approach.

A 23 year old young male after a fall from motor bike complains of chronic pain of 2 months duration. MRI shows a well defined, regular, complex heterogenously altered lobulated completely intraosseous lesion in the subchondral location of the glenoid with no expansion / bleed / labral / cartilage / joint involvement. The differential diagnosis is possibly intraosseous ganglion, post traumatic cyst ( no bleed or fluid / fluid level or heterogenity would make this less likely ), osteoid osteoma ( absence of nidus make this unlikely). Caries sicca ( uncommon location, septal indentification predomiant fluid make this less likely). Case by Dr MGK Murthy and Mr Abdul Hamid.

Teaching points

Intraosseous ganglion cyst are uncommon entities in general with femur and medial malleolus accounting for majority of them, followed by knee and ankle regions. Bone scan / X-ray would suggest presence of activity and no significant calcification.