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CASE REVIEW                                                       SIMPLE BONE CYST WITH FRACTURE MERCURY IMAGING INSTITUTE  SCO 172-173 SEC 9C  CHANDIGARH MERCURY IMAGING CENTRE  SCO 16-17 SEC 20D CHANDIGARH 24 Yr old  Female  H/o fall and pain in the Rt hip joint .
Altered MR signal is appreciated in the Rt femur - subcapitate , neck , interochanteric and proximal shaft region. The lesion has following morphological characters : Central / expansible  lesion with Lobulated  contour. Narrow zone of the transition. Primarily involving medullary cavity with associated thinning of the cortex . Size : 82mm x 39mmx 38mm ( longitudinal x anteroposterior x transverse ). MR signal character : Intermediate on T1, heterogeneously hyperintense on t2/ stir,  with interspread bloom On GRE . Features are corroborative with fluid  and interspread haemorrhage in the core of the lesion.  Cortical break appreciated along the medial aspect of the proximal femoral shaft (just below the lesser trochanter ) . Reactionary edema / hematoma appreciated in the adjacent myofascial planes ( primarily vastusintermedius involved ) . MR  Bilateral hip joints done
HETEROGENOUSLY HYPERINTENSE ON T2 INTERMEDIATE ON T1W HETEROGENOUSLY HYPERINTENSE  ON FATSAT INTERSPREAD BLOOM ON GRE  S/O HAEMORRHAGE
INTERSPREAD BLOOM ON GRE SUGGESTIVE OF HAEMORRHAGE  IN THE LESION.
HYPERINTENSE SIGNAL OF THE LESION  ON FAT SATURATION- SEQUENCE CORTICAL BREAK
ALTERED MR SIGNAL  IN RT PROXIMAL FEMORAL SHAFT WITH INTERSPREAD HETEROGENOUSITY . APPRECIATE : NARROW ZONE OF THE TRANSITION .  EXPANSILE  NATURE  CENTRAL LOCATION  CORTICAL BREAK
SHARP ZONE OF TRANSITION .      LESION LIMITED BY THE PHYSEAL SCAR SMOOTH HOMOGENOUS INTERMEDIATE SIGNAL ON T1 W
Simple bone cyst / unicameral bone cyst  a brief .................................... Unicameral / simple bone cyst . 5 % of primary bone tumors Etiology                                                  ? Trauma                                         ? Vascular anomaly  3 to 19 years  Occurs during active phase of growth Asymptomatic unless fractured. Usually in proximal femur , proximal humerus Intramedullary centric metaphyseal lesion adjacent to epiphyseal cartilage  migrating to diaphysis  with growth.   2 to 3 cm radiolucent with long axis parallel to the long axis of the bone .  Fine sclerotic boundary . Fallen fragment sign if fractured                                                           (  centrally  dislodged fragment  falls into the dependant position) .

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Simple bone cyst

  • 1. CASE REVIEW SIMPLE BONE CYST WITH FRACTURE MERCURY IMAGING INSTITUTE SCO 172-173 SEC 9C CHANDIGARH MERCURY IMAGING CENTRE SCO 16-17 SEC 20D CHANDIGARH 24 Yr old Female H/o fall and pain in the Rt hip joint .
  • 2. Altered MR signal is appreciated in the Rt femur - subcapitate , neck , interochanteric and proximal shaft region. The lesion has following morphological characters : Central / expansible lesion with Lobulated contour. Narrow zone of the transition. Primarily involving medullary cavity with associated thinning of the cortex . Size : 82mm x 39mmx 38mm ( longitudinal x anteroposterior x transverse ). MR signal character : Intermediate on T1, heterogeneously hyperintense on t2/ stir, with interspread bloom On GRE . Features are corroborative with fluid and interspread haemorrhage in the core of the lesion. Cortical break appreciated along the medial aspect of the proximal femoral shaft (just below the lesser trochanter ) . Reactionary edema / hematoma appreciated in the adjacent myofascial planes ( primarily vastusintermedius involved ) . MR Bilateral hip joints done
  • 3. HETEROGENOUSLY HYPERINTENSE ON T2 INTERMEDIATE ON T1W HETEROGENOUSLY HYPERINTENSE ON FATSAT INTERSPREAD BLOOM ON GRE S/O HAEMORRHAGE
  • 4. INTERSPREAD BLOOM ON GRE SUGGESTIVE OF HAEMORRHAGE IN THE LESION.
  • 5. HYPERINTENSE SIGNAL OF THE LESION ON FAT SATURATION- SEQUENCE CORTICAL BREAK
  • 6. ALTERED MR SIGNAL IN RT PROXIMAL FEMORAL SHAFT WITH INTERSPREAD HETEROGENOUSITY . APPRECIATE : NARROW ZONE OF THE TRANSITION . EXPANSILE NATURE CENTRAL LOCATION CORTICAL BREAK
  • 7. SHARP ZONE OF TRANSITION . LESION LIMITED BY THE PHYSEAL SCAR SMOOTH HOMOGENOUS INTERMEDIATE SIGNAL ON T1 W
  • 8. Simple bone cyst / unicameral bone cyst a brief .................................... Unicameral / simple bone cyst . 5 % of primary bone tumors Etiology ? Trauma ? Vascular anomaly 3 to 19 years Occurs during active phase of growth Asymptomatic unless fractured. Usually in proximal femur , proximal humerus Intramedullary centric metaphyseal lesion adjacent to epiphyseal cartilage migrating to diaphysis with growth. 2 to 3 cm radiolucent with long axis parallel to the long axis of the bone . Fine sclerotic boundary . Fallen fragment sign if fractured ( centrally dislodged fragment falls into the dependant position) .