CASE REVIEW SIMPLE BONE CYST WITH FRACTURE

24 Yr old Female H/o fall and pain in the Rt hip joint .

MERCURY IMAGING INSTITUTE SCO 172-173 SEC 9C CHANDIGARH

MERCURY IMAGING CENTRE SCO 16-17 SEC 20D CHANDIGARH

MR Bilateral hip joints done

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 vastus intermedius involved ) .

INTERMEDIATE ON T1W

INTERSPREAD BLOOM ON GRE S/O HAEMORRHAGE

HETEROGENOUSLY HYPERINTENSE ON T2

HETEROGENOUSLY HYPERINTENSE ON FATSAT

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 :1. NARROW ZONE OF THE

TRANSITION . 2. EXPANSILE NATURE 3. 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) .