Subscribe to RSS
DOI: 10.1055/s-0042-1743285
Plain Radiologic Assessment of Unicameral and Aneurysmal Bone Cysts: Differential Diagnosis
Article in several languages: español | EnglishAbstract
Objective To describe our experience in the differential diagnosis of unicameral and aneurysmal bone cysts using plain radiography.
Patients and method We included patients under 20 years of age with radiographs of histologically-confirmed unicameral or aneurysmal bone cysts found on the Chilean National Bone-Tumor Registry. The radiographs were evaluated by two experienced radiologists. We compared the demographic variables of the patients, and the clinical and radiological variables of both tumors.
Results A total of 97 patients met the inclusion criteria, 65% of whom had simple bone cysts, and 35%, aneurysmal bone cysts. No differences were found regarding age, the bone affected, the size of the lesion, bone expansion, nor cortical thinning. Gender, clinical presentation, cortical interruption, and location of the lesion on the longitudinal and transverse bone axes are parameters that could be used in the differential diagnosis of both cysts.
Discussion According to the literature, unicameral and aneurysmal bone cysts are frequent benign lesions that are difficult to differentiate merely through plain radiographs. Magnetic resonance imaging enables a better anatomical characterization and provides sensitivity and specificity to the diagnosis. However, its availability is limited, and it should be preceded by plain radiography.
Conclusion Plain radiography is still the initial imaging study of choice in patients with clinical suspicion of bone tumor, even in those centers where magnetic resonance imaging is available. Certain demographic and radiological characteristics guide physicians in the differential diagnosis of unicameral and aneurysmal bone cysts.
Nivel de evidencia: Nivel 3
Level of evidence: Level three
Publication History
Received: 05 April 2021
Accepted: 24 November 2021
Article published online:
20 May 2022
© 2022. Sociedad Chilena de Ortopedia y Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
Referencias
- 1 Vlychou M, Athanasou NA. Radiological and pathological diagnosis of paediatric bone tumours and tumour-like lesions. Pathology 2008; 40 (02) 196-216
- 2 Wyers MR. Evaluation of pediatric bone lesions. Pediatr Radiol 2010; 40 (04) 468-473
- 3 Costelloe CM, Madewell JE. Radiography in the initial diagnosis of primary bone tumors. AJR Am J Roentgenol 2013; 200 (01) 3-7
- 4 Berquist TH, Dalinka MK, Alazraki N. et al. Bone tumors: American College of Radiology— ACR appropriateness criteria. Radiology 2000; 215 (Suppl): 261-264
- 5 Wilkins RM. Unicameral bone cysts. J Am Acad Orthop Surg 2000; 8 (04) 217-224
- 6 Unicameral Bone Cyst | BoneTumor.org [Internet]. [Cited 2021 Apr 5]. Available from: http://www.bonetumor.org/tumors-bone/unicameral-bone-cyst
- 7 Unicameral Bone Cyst | STATdx.com [Internet]. [Cited 2018 Oct 12]. Available from: https://my.statdx.com/STATdxMain.jsp?rc=false#dxContent;unicameral_bone_cyst_dx
- 8 Mirra JM. Bone Tumors: Clinical, Radiologic, and Pathologic Correlations. Philadelphia: Lea & Febiger; 1989. 2. 1233-4
- 9 Reynolds J. The “fallen fragment sign” in the diagnosis of unicameral bone cysts. Radiology 1969; 92 (05) 949-953 , passim
- 10 Baig R, Eady JL. Unicameral (simple) bone cysts. South Med J 2006; 99 (09) 966-976
- 11 Rapp TB, Ward JP, Alaia MJ. Aneurysmal bone cyst. J Am Acad Orthop Surg 2012; 20 (04) 233-241
- 12 Cottalorda J, Bourelle S. Modern concepts of primary aneurysmal bone cyst. Arch Orthop Trauma Surg 2007; 127 (02) 105-114
- 13 Oliveira AM, Perez-Atayde AR, Inwards CY. et al. USP6 and CDH11 oncogenes identify the neoplastic cell in primary aneurysmal bone cysts and are absent in so-called secondary aneurysmal bone cysts. Am J Pathol 2004; 165 (05) 1773-1780
- 14 Zehetgruber H, Bittner B, Gruber D. et al. Prevalence of aneurysmal and solitary bone cysts in young patients. Clin Orthop Relat Res 2005; 439 (439) 136-143
- 15 Leithner A, Windhager R, Lang S, Haas OA, Kainberger F, Kotz R. Aneurysmal bone cyst. A population based epidemiologic study and literature review. Clin Orthop Relat Res 1999; (363) 176-179
- 16 Cottalorda J, Gouin F. Kyste osseux anévrismal. (Aneurysmal bone cyst). Rev Chir Orthop Repar Appar Mot 2007; 93 (01) 5-16
- 17 Aneurysmal Bone Cyst | STATdx.com [Internet]. [Cited 2018 Oct 12]. Available from: https://my.statdx.com/STATdxMain.jsp?rc=false#dxContent;aneurysmal_bone_cyst_dx
- 18 Mahnken AH, Nolte-Ernsting CC, Wildberger JE. et al. Aneurysmal bone cyst: value of MR imaging and conventional radiography. Eur Radiol 2003; 13 (05) 1118-1124
- 19 Jalan D, Gupta A, Elhence A. et al. Primary aneurysmal bone cyst of the calcaneum: A report of three cases and review of literature. The Foot 2021; 47: 101795