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Canal of Nuck Cyst

Last Updated on August 14, 2020

Canal of Nuck cyst MRI and CT findings
Canal of Nuck cyst MRI and CT

Pathophysiology of the Canal of Nuck

  • Extension of the parietal peritoneum follows the round ligament as it passes to the inguinal canal.
  • Usually gets obliterated.
  • This evagination of the parietal peritoneum =  the canal of Nuck =  female counterpart of processus vaginalis in men.
  • If it is:
    • Completely patent: Avenue for an indirect inguinal hernia and hydrocele (Canal of Nuck hernia).
    • Obliterated at the level of both the superficial and deep inguinal rings: Fluid may be trapped in between both ends of the canal, creating a Canal of Nuck cyst.
    • Obliterated at lower end – Infantile hydrocele / encysted hydrocele.
  • Hydrocele vs cyst canal of Nuck : The terms hydrocele and cyst of Canal of Nuck are used interchangeably but these are separate pathologies.
  • Symptoms: It usually presents as a painless swelling in the inguinal region. Infection can cause pain.

Imaging appearances:

  • Canal of Nuck cyst is an inguinal cyst in females.
  • US : Cystic lesion in the inguinal canal with posterior acoustic attenuation.
  • CT : Hypodense lesion with our without internal septations.
  • MRI: T1 isointense, T2 hyperintense, typical appearance of a cystic lesion.
  • Can show peripheral enhancement.

Differentials for Canal of Nuck cyst

  • Inguinal hernia containing fluid in patients with ascites.
  • Soft tissue tumor.
  • Endometriosis cyst
  • Cyst
  • Abscess
  • Lymphadenopathy


Surgical excision or conservative management depending on patient presentation.

Detailed video with PACS based case images:

Canal of Nuck Cyst CT and MRI findings
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Dr. Amar Udare, MD

Dr. Amar Udare has completed medical school from KEM Hospital Mumbai and radiology residency from Tata Memorial Hospital, Mumbai. He is a board-certified radiologist.

He has also completed fellowships in body imaging from Mumbai and Ottawa and is currently pursuing a fellowship in cross-section imaging at McMaster University, Canada.

He has a passion for teaching and his area of interest is body imaging. He started the website, RadioGyan to share radiology resources and cases to help residents and radiologists (#FOAMrad #radiology). He was a semi-finalist for the 2018 and 2020 Aunt-Minnie Most effective Radiology Educator Award.

You can read my most recent publications on: PubMed and Google Scholar

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