Sequential tibial and peroneal intraneural ganglia arising from the superior tibiofibular joint

We present a patient who developed a peroneal intraneural ganglion and an adventitial cyst following the incomplete treatment of a tibial intraneural ganglion. These separate cysts all originated from the superior tibiofibular joint and dissected along their respective articular branches. A logical mechanistic explanation for these coexisting cysts is provided, which highlights the shared pathogenesis-its joint-related nature-rather than a multifocal de novo process. These observations would not only be consistent with, but would extend previous evidence in support of, the unifying articular (synovial) theory.