Plain Radiologic Assessment of Unicameral and Aneurysmal Bone Cysts: Differential Diagnosis

Abstract

Objective To describe our experience in the differential diagnosis of unicameral and aneurysmal bone cysts using plain radiography.

Patients and method We included patients under 20 years of age with radiographs of histologically-confirmed unicameral or aneurysmal bone cysts found on the Chilean National Bone-Tumor Registry. The radiographs were evaluated by two experienced radiologists. We compared the demographic variables of the patients, and the clinical and radiological variables of both tumors.

Results A total of 97 patients met the inclusion criteria, 65% of whom had simple bone cysts, and 35%, aneurysmal bone cysts. No differences were found regarding age, the bone affected, the size of the lesion, bone expansion, nor cortical thinning. Gender, clinical presentation, cortical interruption, and location of the lesion on the longitudinal and transverse bone axes are parameters that could be used in the differential diagnosis of both cysts.

Discussion According to the literature, unicameral and aneurysmal bone cysts are frequent benign lesions that are difficult to differentiate merely through plain radiographs. Magnetic resonance imaging enables a better anatomical characterization and provides sensitivity and specificity to the diagnosis. However, its availability is limited, and it should be preceded by plain radiography.

Conclusion Plain radiography is still the initial imaging study of choice in patients with clinical suspicion of bone tumor, even in those centers where magnetic resonance imaging is available. Certain demographic and radiological characteristics guide physicians in the differential diagnosis of unicameral and aneurysmal bone cysts.

Keywords

differential diagnosis - bone cyst - aneurysmal bone cyst - radiography - bone neoplasms

Nivel de evidencia: Nivel 3

Level of evidence: Level three

Publikationsverlauf

Eingereicht: 05. April 2021

Angenommen: 24. November 2021

Artikel online veröffentlicht:
20. Mai 2022

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