from Section I - Musculoskeletal radiology
Published online by Cambridge University Press: 22 August 2009
Characteristics
Can occur at any age. Commonest in 10–30 year olds with the majority arising prior to epiphyseal fusion.
Any bone may be affected but most commonly occur in long-bone metaphyses, especially the lower limb.
Aetiology unknown.
Clinical features
Pain associated with expansile lesions.
Pathological fractures may occur.
May be visible or palpable if sufficiently large.
Radiological features
Well-defined radiolucent cyst, often eccentric within bone. Marked ‘soap-bubble’ expansion may be seen.
Usually trabeculated with a thin intact cortex (narrow transition zone).
No periosteal reaction (except when fractured).
Within the spine, posterior elements are more commonly involved.
May be mistaken for other cyst-like lesions – see Bone cysts.
MRI/CT – fluid levels within cyst due to blood sedimentation (in up to 35%).
Management
Curettage and bone grafting, or substitute grafting.
If the ABC recurs, then consider bone cement rather than bone graft in the revision procedure.
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