Aneurysmal bone cyst - radius

Case contributed by Assoc Prof Frank Gaillard

Presentation

Child with a painful left forearm.

Patient Data

Age: Child

Expansile mass in the mid-diaphysis of the radius. Loss of cortex and aggressive appearances.

Increase uptake in the blood pool as well as delayed images. 

The expansile mid-radial mass contains multiple septa and fluid-fluid levels. Fluid-fluid levels are seen in ABC and telangiectatic osteosarcoma.

The forearm following resection and grafting.

Case Discussion

X-rays of the forearm of a child demonstrate an expansile bubbly lesion of the mid radial diaphysis, with irregular margins, no convincing matrix mineralization and no convincing soft tissue extra-osseous mass.

Bone scans demonstrate increased uptake.

MRI elegantly demonstrates multiple fluid-fluid levels, which although non specific suggest the diagnosis of an aneurysmal bone cyst (ABC). This was confirmed on histology following resection and grafting.

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