Bone cyst
| Classification according to ICD-10 | |
|---|---|
| M85.4 | Solitary bone cyst |
| M85.5 | Aneurysmal bone cyst |
| ICD-10 online (WHO version 2019) | |
A bone cyst is a benign tumor-like bone lesion that has a fluid-filled and z. T. represents a cell-filled cavity in the bone. Radiologically, one or more chambers can be seen in the X-ray image . The cysts in young bones are mostly discovered as a chance finding on X-rays after an accident injury or as the cause of so-called pathological fractures (fractures with reduced bone strength).
to form
Henry Lewis Jaffe identified their entities . One differentiates:
- Simple (juvenile) bone cyst : benign, primarily single-chamber, fluid-filled cavity, mostly in the metaphyseal medullary canal . Usually only noticeable through a spontaneous fracture . The classic X-ray sign is the fall fragment sign.
- Aneurysmal bone cyst (AKZ) : Benign, multi-chambered bone lesion. A classic finding in the MRI is the "mirror formation" of the cyst contents with different signal intensities.
therapy
The therapy is crucially dependent on the circumstance of the finding: If a bone cyst is found incidentally on the X-ray, a sample biopsy should be carried out after further clarification by an MRI examination , in order to follow up with an adequate therapy after confirming the type of cyst (juvenile or aneurysmal).
- Simple (juvenile) bone cyst : The procedure established today is intramedullary osteosynthesis (prevot nailing) of the bone. In some cases, a fracture is stabilized and the bone cyst is stimulated to heal at the same time. Some groups still use an injection of cortisone solution or a perforation with opening of the cyst wall to heal non-fractured juvenile cysts.
- Aneurysmal bone cyst : After the diagnosis from the biopsy has been confirmed, the cyst is surgically removed and the cavity is filled with bone cement . The course is controlled. If no new cyst tissue has grown after 2 years, which can be seen very well by the missing border around the bone cement seal, the cement can be surgically removed and your own bone from the iliac crest ( cancellous bone ) can be filled in instead. After a long bony remodeling process, the cyst region is fully resilient again.
literature
- Jürgen Freyschmidt : Skeletal Diseases . Clinical-radiological diagnosis and differential diagnosis. 3. Edition. Springer 2010, ISBN 978-3-540-61601-6 .
- K. Bohndorf, H. Imhof, W. Fischer: Radiological diagnosis of bones and joints. 2nd Edition. Thieme, Stuttgart 2006, ISBN 3-13-110982-3 .
Web links
- S1 guidelines for bone cysts from the German Society for Pediatric Surgery (DGKCH). In: AWMF online (as of May 31, 2013)
- The aneurysmal bone cyst
