Bone Cyst: Symptoms, Diagnosis and Treatment
A bone cyst is a lesion usually seen in the first two decades of life. Usual age of patients is between 5 to 15 years. It is more common in males. It consists of a cavity present inside the bone. The cavity is filled with clear yellowish fluid.
It is predominantly located at upper or lower ends of long bones like
- the upper end humerus or arm bone
- the upper end of femur or thigh bone
- lower end of humerus
- lower end of femur
- tibia or shin bone
- forearm bones
The upper end of the humerus and femur account for the majority of lesions.
Diagnosis of the cyst is by x ray examination. At times a MRI scan may be required if the diagnosis is not clear on x rays.
Usually the cyst causes no problems until a fracture occurs. The fracture involves the cyst and usually occurs following trivial injury as the bone around the cyst is weak.
At times the fracture may also occur following some unusual activity. A cyst in the lower limb may present as a limp.
Healing of the fracture occurs rapidly in a few weeks. Sometimes along with the healing of the fracture the cyst becomes obliterated. In such conditions no further treatment is required.
If the cyst remains after the fracture has healed then treatment for the cyst can be initiated. Treatment includes the following methods
- Aspiration of cyst fluid and instillation of methylprednisolone injection in to the cyst cavity
Instillation of methylprednisolone has a 70 to 80% success rate in healing the cyst. More than one instillation of methylprednisolone may be required. High levels of prostaglandins are present in the cyst fluid. Methylprednisolone reduces these levels.
During surgery the cyst is opened through an incision and the inner lining of the cyst is removed. After this the cyst is packed with bone chips. Surgery is done if methylprednisolone instillation fails to cure the bone cyst.
A newer treatment being tried for this condition is injection of the patients own bone marrow in to the cyst. Initial results by this method have been shown to be good.
Complications of bone cyst include
- abnormal growth of bone causing deformity or shortening in the limb
- recurrence of the cyst (even after surgery)
Growth disturbance is more likely to occur if the cyst extends beyond the growth plate. Is such patients surgery should be avoided as it can cause trauma to the growth plate. Injection of methylprednisolone should be preferred.
Frequently Asked Questions
What are the chances of recurrence after surgery?
25% of cysts reform after surgery.
What treatment is done in this condition?
The cyst is re-operated if it is found to be increasing in size and weakening the bone significantly.
I hope the information provided was helpful. If you have any query you can ask me at the contact me page.
This page was created on 22nd October 2010
Other bone tumors
Aneurysmal Bone Cyst
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