Presentation
Previously healthy child, presenting through the clinic with complaints of pain in the left hip and inability to walk. She was initially thought to have irritable hip and she was treated like this but as the pain became worse and could not walk anymore, She is currently unable to walk. She was assessed by Doctor, she had no recent illness or fevers. There is no history of sick contact. She is fit and healthy otherwise and no other medical condition.
Patient Data
Large lucent area, cyst/pathologic fracture involving the left proximal femur.
There is a proximal femoral cyst located centrally with thinning of the cortex. It contains a few thin septa and a fluid level. There is edema in the surrounding soft tissues. There is high T2 signal in the adjacent marrow representing edema.
The epiphyseal-metaphyseal junction with a growth plate appears unremarkable. The acetabulum and the triradiate cartilage appear unremarkable. The acetabular labrum is normal in appearance. Images of the hip joints demonstrate no labral tear, the articular cartilage of the hip joint is maintained. There is no feature of effusion.
Conclusion: Findings are suggestive of identifiable bone cyst complicated by a pathologic fracture.
Case Discussion
This case demonstrates the clear features of bone cyst complicated by a pathologic fracture.
Unicameral bone cyst (UBC) is a very common benign bone tumor in children. It is a space in the bone that is filled with fluid instead of with bone. It usually occurs in the long bones near a joint and growth plate, such as near the knee, hip, or shoulder. They are usually not painful unless there is also a fracture (break) in the bone through the UBC.
Appreciation is extended to Dr.Ajay Prashanth Dsouza, Dr.Muhammad Anwar, Jukha Shater Ali Ali AL Badawi, and fellow Radiographers / Radiology Nurses, Department of Radiology, Al Jalila Children's Speciality Hospital, Dubai, UAE, for contributing to this case.
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