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Aneurysmal bone cyst of fibula

Case contributed by Dr Amit Tripathi


Ankle pain

Patient Data:

Age: 16 years
Gender: Female
Race: Caucasian

Right ankle x-ray

Modality: X-ray

Lucent expansile lesion in distal fibula, no pathological fracture

Bone scan

Modality: Nuclear medicine

Tracer uptake is seen both during blood pool and delayed phases. 

MRI right ankle

Modality: MRI

A lesion in the distal fibula is demonstrated with extension through the lateral cortex and into the adjacent soft tissues. It is multiloculated with many fluid-fluid levels, best seen on axial imaging. Enhancement of septae and rim is present. The margins of the lesion are very well defined, and although there is oedema in the surrounding soft tissues, there is no bone marrow oedema in the adjacent normal bone. 

This patient went on to have surgery and histology confirmed the diagnosis of an aneurysmal bone cyst (ABC). 

X-ray right ankle: Post-Op

Modality: X-ray

Films have been obtained post surgical treatment.

Distribution of aneurysmal bones cysts

Modality: Diagram

Case Discussion:

This case demonstrates typical multi-modality imaging features of an aneurymal bone cyst (ABC), in albeit a somewhat atypical location. 

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