Presentation
Chronic left heel pain.
Patient Data
Well defined expansile osteolytic lesion with thin sclerotic margins seen involving the posterior half of calcaneus bone.
Increased uptake in the left calcaneus, suggestive of a bone tumor. No other significant abnormal uptake to suggest distant metastasis.
Well-defined expansile multiloculated mass (measuring approximately 4.5 x 3.8 x 4.5 cm) in the calcaneus.
Approximately 41 x 47 x 48 mm well-defined lobulated multiloculated mass in calcaneus;
expansile nature with adjacent cortical thinning
intralesional multiple hemorrhage-fluid level and peripheral dark signal intensity rim
intralesional mild thin septal enhancement
mild perilesional bone marrow edema
no solid enhancing portion
Case Discussion
Gadolinium was given to differentiate between the primary and secondary aneurysmal bone cysts by detecting internal soft tissue components that indicate underlying primary pathology (since the secondary ABC developed secondary to an underlying lesion).
Unfortunately, a pathological fracture occurred for this patient after a traumatic event.
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