Aneurysmal bone cyst
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Aneurysmal bone cyst

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    Aneurysmal bone cyst Aneurysmal bone cyst Presentation Transcript

    •  Aneurysmal bone cyst  Unicameral bone cyst  Giant cell tumour
    • Biopsy proven aneurysmal bone cyst Presently 3 months post biopsy
    • 1. Currettage and allow spontaneous healing 2. Currettage and bone grafting 3. Currettage and cryotherapy 4. Radiotherapy 5. Intralesional injection steroid, calcitonin 6. Embolisation of feeding vessel 7. Sclerotherpy
    • J Bone Joint Surg [Br] 2006;88-B:1212-16.
    •  Percutaneous sclerotherapy has emerged as an excellent method of treatment.  Hydroxypolyaethoxydodecan is a sclerosing agent.  It has been sucessfully used in the treatment of AV malformations of 1. GI tract 2. varicose veins 3. Telengiectases, varicose veins
    •  Sample size = 72  Male= 46, female= 26  Mean age= 15.6  39 lesions – upper limb 29 lesions - lower limb 4 lesions - axial skeleton  Mean follow up 34 months ( 2yrs & 10 months)
    •  All pts underwent biopsy confirmation  Treatment 3 months after biopsy ( giving time for spontaneous healing)  Preop volume of the lesion was calculated
    •  < 15 yrs GA, > 15 yrs local  16 gu needle or bone marrow needle used.  Under C arm guidance  1 ml for 1cm3 volume  Lock the needle for 1 min so that no back flow  No more than 10 ml was given
    • • Follow up 1. 6 weeks 2. 12 weeks 3. 6 months there after
    • 1. Time at which the pain had resolved. 2. The cortical thickness of the wall of the cyst had started reforming. 3. Lesion had stopped growing in size.  2nd injection was given if any of the above criteria were not met.
    •  grade I (< 25% of the initial lesion) 66%  grade II (25% to 49%) 30.5%  grade III (50% to 74%) 2.8%  grade IV (75% or more).
    • 97% success at the end of final follow up
    •  Recurrence 2 cases  Induration at the site of injection 18 cases,  hypopigmentation 3 cases,  local inflammatory reaction,  episode of dizziness
    •  hypopigmentation,  necrosis at the site of the injection in the case of extravasation,  pulmonary embolism,  osteomyelitis,  allergic reactions  This series had only hypopigmentation
    •  skin conditions at the site of injection,  heart disease,  asthma  pregnancy