Skip to main content Accessibility help
×
Hostname: page-component-7bb8b95d7b-s9k8s Total loading time: 0 Render date: 2024-09-19T15:33:45.626Z Has data issue: false hasContentIssue false

Bone cysts

from Section I - Musculoskeletal radiology

Published online by Cambridge University Press:  22 August 2009

James R. D. Murray
Affiliation:
Bath Royal United Hospital
Erskine J. Holmes
Affiliation:
Royal Berkshire Hospital
Rakesh R. Misra
Affiliation:
Buckinghamshire Hospitals NHS Trust
Get access

Summary

Characteristics

  • Solitary or unicameral bone cysts occur in childhood, typically affecting the metaphysis of a long bone, most commonly the proximal humerus and femur.

  • Simple cysts are not tumours and often heal spontaneously.

  • Contain straw-coloured fluid and are surrounded by a flimsy fibrous tissue membrane which contain giant cells.

  • In actively growing cysts there will be a zone of bone resorption ‘behind’ the cyst.

  • M:F = 3:1.

Clinical features

  • Often present with fracture through a cyst.

  • Otherwise asymptomatic.

Radiological features

  • Well-circumscribed (metaphyseal) radio-lucency, with a fine sclerotic border (narrow zone of transition), and long axis parallel to long axis of host bone.

  • Often extends to the physis, associated cortical thinning and expansion of the metaphysis.

  • A gravity-dependent fragment may be seen within the cyst after fracture (fallen fragment sign).

Management

  • If asymptomatic (incidental diagnosis), observe with repeat X-rays. Reassure parents and warn about fractures – avoid contact sports.

  • Actively growing cysts – aspiration and steroid injection. If the cyst still enlarges or fractures, then curettage and bone (or substitute) grafting.

  • Fracture – treat the fracture non-operatively and the cyst is likely to fill in as the fracture heals.

  • For recurrent fractures, curettage, grafting +/− stabilisation is the treatment of choice.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×