“ This is a benign lesion, more common in aged less than 30 years ( peak age is 16 years ) ,M=F. It is a lucent, expansile lesion contain...
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This is a benign lesion, more common in aged less than 30 years (peak age is 16 years) ,M=F.
It is a lucent, expansile lesion containing multiple thin-walled, blood-filled cavities.
It presents with pain. Giant cell tumours (GCT) are a common differential, but are found in the third or fourth decade.
APPENDICULAR X-RAY
• May occur anywhere, but the femur is most commonly affected (then ulna and tibia).
• Lytic, expansile metaphyseal lesion with a thinned cortex and fine internal trabeculation (‘soap bubble’ appearance).
• Lesion is eccentric and expansion asymmetrical.
• Check for pathological fractures.
SPINE X-RAY
• May be found anywhere in the spine, but more common in the posterior elements (especially the spinous processes).
• May cross intervertebral disc or facet joints.
• Vertebral collapse.
MRI
• Multiple cysts of different signal intensity (i.e. blood products) with a low signal rim and heterogenous enhancement post-gadolinium
• Fluid-fluid levels within the cysts—non-specific, but if they occupy >70% of the lesion, then ABC is favoured.
• Hyperintense to muscle on T1.
• Heterogenous with areas of low signal intensity on T2.
• Marrow oedema is not typical.
CT
• Check for fluid-fluid levels (also seen in GCTs and teleangiectatic osteosarcoma)
• Assess soft tissue extent of the lesion and internal matrix.
Scintigraphy
- ‘Doughnut’ sign: a photopenic centre with increased peripheral uptake
Aneurysmal bone cyst. Frontal radiograph of the right humerus demonstrating osteopenia, medullary expansion, thinned cortices and coarsening of the trabeculae.
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