Bone Pathology Database

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2nd image
Postop Xray
Third image
18 months after grafting
The differential diagnosis included fibrous dysplasea or a large ganglion cyst They may look similar to chondroblastoma, osteoblastoma, enchondroma, or bone abscesses.
At biopsy the lesion consisted of a large cystic lined with a membrane. Histology confirmed it was an intraosseous ganglion. Because of the risk of fracture the cyst was filled with a vascularised portion of the crista Iliaca.
One yr later the cyst had consolidated well.The lower Xray shows the postoperative patient. The superior screw is to fix the sartorial attachment which had been undermined by the large donor graft. The lower screw is securing the bone within the cyst.
Intra-osseous ganglion is typically seen in adults between the ages of 20 to 60 years of age. It is typically seen within the articular ends of long bones along the non-weight bearing side. It is usually seen as an eccentric lucent lesion with a sclerotic margin that does not communicate with the joint cavity.
Biopsy of a gangion cyst is often not advisable but in a high stress area such as this, it was felt necessary because of the danger of fracture.

Record 15