Simple bone cyst (unicameral)

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  • Good effort and attempt, even I did not know, that metapyseal bones, in such conditions, do not remodel normally !!!
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Simple bone cyst (unicameral)

  1. 1. Simple Bone Cyst (Unicameral) Maryam Sharifian MSc student of O&P at Isfahan University Of Medical science 1
  2. 2. Discussion a membrane lined cavity containing a clear yellow fluid.  occurrs most often in children 4-10 years of age;  lesions remain asymptomatic unless complicated by fracture.  they enlarge during skeletal growth and become inactive, or latent, after skeletal maturity.  2
  3. 3. Active cysts Develop in patients under 10 years of age • Cyst arises adjacent to growth plate & may grow to fill most of metaphysis Bone may be slightly expanded within cortical shell • May cause pathologic fracture 3
  4. 4. Passive cysts patients are usually over 12 years of age cysts cease to expand become increasingly separated from growth plate (more than 1-2 cm) have thicker bony wall than active lesions may show evidence of healing or ossification less likely to result in fx 4
  5. 5. Causes…  The cause of a unicameral bone cyst remains unknown. Theories have been proposed but none have been definitively proven.  One of these theories is that the cysts result from a disorder of the growth plate.  Another is that the cysts result from problems with circulation that are caused by a developmental anomaly in the veins of the affected bone.  The role trauma plays in the development of these cysts is unknown. 5
  6. 6. Symptoms…  Unless there has been a fracture, bone cysts are without symptoms.  They may occasionally be discovered by chance on x-rays obtained for other reasons.  There is no mass or tenderness unless there is a fracture.  There may be an abnormal angulation of the limb secondary to the fracture or shortening of the limb if the adjacent growth plate is involved. 6
  7. 7. Location lesion appears to arise from the growth plate & in early stages, lesion is lies adjacent to growth plate; • typically the simple bone cyst will have a central location, whereas an ABC will have a slightly eccentric location; - predilection for the metaphysis of long bones; - proximal humerus (50% of cases) - proximal tibia - proximal femur (40%) - foot:Calcaneal Bone Cysts 7
  8. 8. Radiographs show a central, well marginated & symmetric radiolucent defect in metaphysis metaphyseal bone does not remodel normally metaphysis is broader than normally seen but not broader than with width of epiphyseal plate thin rim of non reative bone borders the unicameral bone cyst 8
  9. 9. Radiography 9
  10. 10. 10
  11. 11. Differential Diagnosis Fibrous dysplasia Aneurysmal bone cyst 11 • Monostotic fibrous dysplasia is usually eccentric rather than central and diaphyseal rather than metaphyseal • Periosteal reaction is greater in fibrous dysplasia than simple bone cyst; • Enlarge metaphysis to greater than width of the epiphyseal plate;
  12. 12. Histologic Examination Active cyst have a mesothelial membrane lining thin margin of bone Inner wall of bone adjacent to membrane may be lined by osteoclasts 12 Between membrane & osteoclasts is a layer of areolar tissue containing fibroblastic and multinucleated giant cells
  13. 13. Treatment 1 2 • Simple cysts are treated with curettage and bone grafting 3 13 • Goal of treatment is prevention of pathologic fracture • Recurrence is high for active cysts (50%) & low for latent cysts (10%)
  14. 14. Thank you 14

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