SIMPLE BONECYST

Jaya ruban
121303660
Batch 34
group A1
Simple Bone Cyst

Also known as Unicameral Bone Cyst.

Are entirely benign lesion of unknown aetiology.

Are always unilocular.

Age

Childhood and early adolescense

Before the epiphyseal fusion occur.

In adults, some lesions occur after skeletal maturation
in such bones as the Calcaneus, Talus
Location
Typically Intramedullary.
Most frequently found in the metaphysis.

Sites :
Proximal humerus
Proximal femur
Other long bones
Calcaneus, Talus.
Clinical Features
Asymptomatic and found incidentally.
Only a few produce minor discomfort. May be pain,
swelling and stiffness of adjacent joint.

More than half present due to a pathological fracture.

Pathology
Cyst contains clear liquid unless there has been
contamination by bleeding following a fracture .

Cyst is lined by a thin layer of connective tissue.

Investigations
Plain X-ray film
CT Scan
MRI
Bone Scan.
Plain X-ray
An area of translucency centrally in the metadiaphysis
is characteristic.
The overlying cortex is often thinned and slightly
expansed with no periosteal reaction unless a fracture
has occurred.
Sclerotic reaction is usually present around the
margin.
A serpiginous margin (by prominent ridges of bone)
may cause the cyst to appearmultilocular.
Fallen fragment sign

If there is fracture through this lesion, a dependent

bony fragment may be seen, and this is known as the
fallen fragment sign.
Treatment
1)If small and low risk of fracture

Some cases resolve spontaneously withage.

Intralesional Steroid
An injection of Methylprednisolone Acetate into the
lesion in several intervals for a time span of 6-12 months.

Complications are infection, fracture or recurrence.

2)If risk of fracture or large lesion

Curettage
Bone grafting
It is proceeded after curettage. The empty cavity
is transplanted with donor bone tissue, bone chips or
artificial material.
Differential diagnosis
1. Fibrous dysplasia
2. Aneurysmal bone cyst
3. Giant cell tumor
4. Eosinophilic granuloma
5. Non ossifying fibroma
6. Chondroma.