|Management of benign cystic lesions of bone|
Common Bone lesions appearing cystic on X ray
Patients with cystic bone lesions may present with pain or swelling or the cyst may be noticed incidentally on an X Ray taken for other reasons.
Pain may indicate that the cyst is developing a stress fracture and needs urgent treatment, or it may be present for other reasons such as in the case of a ganglion cyst secondary to degenerative joint disease.
The patient commonly presents with an established fracture through a lesion that appears cystic.
Not all cysts require treatment. In some lesions the danger of biopsy or other surgery may outweigh any benefit.
The following lesions generally do not require operative treatment. Biopsy of bone infarct will create to a stress riser in dead bone. A stress fracture will develop which can not heal and leads to complete fracture of the bone. Similarly a biopsy of a stress fracture will yield callus which may be mistaken by the pathologist as osteoid, leading to misguided surgery such as an amputation or block resection.
Tumor and tumor-like lesions for non operative treatment
As with everything medical, there are exceptions. Any lesion in the above list which is painful, fast growing or large (appears as if it may immanently cause a fracture) will require surgery.