An aneurysmal bone cyst (ABC) is a painful condition in which a cystic (fluid filled cavity) lesion develops in a bone, usually following a fracture or trauma sufficient to alter the venous circulation of the bone.  It can also develop from pre-existing bone tumors.   It is typically found between the ages of 10-30, with the peak age of 16.  The most common site is the knee region, followed by the arm bones, spine, and upper leg (femur).  ABCs have also been documented in small tubular bones of the foot, and skull.

The symptoms of an aneurysmal bone cyst depend on the affected area.   A common presentation is relatively fast onset of pain that rapidly increases in severity over 6-12 weeks.

The  skin surface temperature over the cyst may increase, a hard, bony swelling may be felt , and movement in an adjacent joint may be restricted.

Spinal lesions may cause radiating nerve pain or quadriplegia, and patients with skull lesions may have moderate to severe headaches.

Although aneurysmal bone cysts are relatively rare, I decided to address this disorder because the symptoms may be wrongly interpreted as a sprain or strain, especially for ABCs that affect the posterior elements of the spine.   A wrong diagnosis will lead to the wrong treatment prescription, such as chiropractic adjustments or physical therapy, which can worsen the condition.

If you have a teenager who complains of sudden, focal pain around a bone, frequently the knee, it’s best to take your child to his/her primary care physician, who should order an X-ray.  X-rays are the preferred imaging study to diagnose ABCs.

There are several treatment options for aneurysmal  bone cysts.  Surgical curettage, which is basically scraping out the cyst, embolization of the cyst (blocking its feeding veins and arteries), and injection of drugs to inactivate the cyst.

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