Simple or juvenile bone cyst in MRI scan by RadiologieTV скачать в хорошем качестве

Simple or juvenile bone cyst in MRI scan by RadiologieTV

This video is about the simple or juvenile bone cyst. The simple bone cyst is a benign, fluid-filled cystic lesion of unknow origin. Most often it is located centrally in the metaphysis of long bones. The peak incidence lies in the first two decades. Males are more frequently affected than females. In most cases the cyst is asymptomatic and will only be symptomatic in the presence of a fracture. Radiologically you finde a geographic lytic lesion with a thin scerlotic rim centrally in the medullary cavity. The surrounding bone might be slightly expanded with cortical thinning. Unless there is a pathologic fracture you won't see a periostal reaction of cortical breakthrough. In case of a pathologic fracture the so called fallen fragment is characteristic for the simple bone cyst. This is a broken bone fragment which swims within the cyst and moves in dependent position as the patient changes position. Usually there is no need to do a CT or MRI scan in order to confirm the diagnosis and it has not been done in this case, either. The fracture was treated surgically and the diagnosis intraoperative confirmed. For differential diagnosis you can think of an aneurysmal bone cyst which lies more excentrically though and has a more expansive character. On MRI scan you find fluid-fluid levels which are uncommen for a simpel bone cyst. Another differential diagnosis is the fibrous dysplasia which contains ground glas density radiographically and has a solid content on MRI. A giant cell tumor is like the aneurysmal bone cyst situated more excentrically and doesn't show a scerlotic margin. Also it has a solid content on MRI. The langerhans cell histiocytosis affects the same age group and is hard to differentiate in case of a non-aggressive appearance. Also a complete lytic enchondroma whith cartilagenous matrix can't be differentiated from a simple bone cyst radiographically. Brown tumors are high on top of the differential diagnosis list if other signs of hyperparathyroidism are present like subperiostal and subchondral bone resorption or decreased bone density.