Abstract
Hemorrhagic synovial cysts of the lumbar spine are uncommon but clinically significant due to their potential for rapid symptom progression. Patients often present with severe lower back pain and neurological deficits, which are exacerbated by bleeding within the cyst, leading to an increase in its size. This haemorrhage is typically linked to the rupture of fragile, newly formed blood vessels. MRI is crucial for diagnosis, with these cysts frequently appearing heterogeneously hyperintense on T1-weighted images, although signal characteristics may vary depending on factors such as protein content, blood degradation, and the timing of the hemorrhagic event. While many synovial cysts can be observed without intervention, hemorrhagic transformation often requires surgical excision, and in some cases, emergency surgery is necessary to address severe neurological symptoms. Early diagnosis and treatment are essential to prevent permanent deficits and improve outcomes.
