What is the diagnostic approach for a synovial cyst of the cervical spine?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Article Review Status
Submitted
Under Review
Approved

Last updated: February 12, 2025 • View editorial policy

From the Research

Introduction to Synovial Cysts of the Cervical Spine

Synovial cysts of the cervical spine are rare entities that can cause significant neurological symptoms due to compression of the spinal cord or nerve roots. The diagnostic approach for these cysts involves a combination of clinical evaluation and imaging studies.

Clinical Presentation

Patients with synovial cysts of the cervical spine may present with symptoms such as myelopathy, radiculopathy, or spinal cord compression syndrome, which can include pain, tingling, dysesthesia, and weakness in the upper or lower extremities [ 1, 2, 3 ].

Imaging Studies

Imaging studies play a crucial role in the diagnosis of synovial cysts of the cervical spine. The following imaging modalities can be used:

  • CT Scan: Can show a posterolateral juxtafacet location of the mass, egg-shell calcifications on the wall of the cyst, and air inside the cyst [ 1, 4 ].
  • MRI: Can show the contents of the cyst as iso/hypointense on T1- and hyperintense on T2-weighted images, with a hypointense rim on T2-weighted images that enhances after intravenous administration of gadolinium [ 1, 2, 5 ].

Diagnostic Approach

The diagnostic approach for a synovial cyst of the cervical spine involves:

  • Clinical evaluation to identify symptoms and signs of spinal cord or nerve root compression
  • Imaging studies, including CT scan and MRI, to confirm the presence of a synovial cyst and evaluate its location and size
  • Consideration of other differential diagnoses, such as herniated discs, osteophytes, or other spinal tumors

Treatment Options

Treatment options for synovial cysts of the cervical spine include:

  • Surgical removal: Can provide significant amelioration of symptoms [ 1, 3 ]
  • CT-guided aspiration: Can provide long-lasting symptomatic relief in some patients 2
  • Epidural steroid injection: Can be used in combination with CT-guided aspiration to provide symptomatic relief

Caveats and Considerations

  • Synovial cysts of the cervical spine are rare and can be associated with os odontoideum 5
  • Intracystic hemorrhage can occur, leading to acute presentation with spinal cord compression syndrome 3
  • Surgery should be considered for any cervical synovial cyst due to the risk of bleeding and resulting irreversible neurological damage 3

References

Research

Cervical synovial cysts: case report and review of the literature.

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 1999

Research

CT Guided Aspiration of a Cervical Synovial Cyst. Case Report and Technical note.

Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences, 2007

Research

Calcified synovial cyst of the cervical spine: CT and MR evaluation.

Journal of computer assisted tomography, 1990

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.