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Imaging Findings of Calcaneal Cyst and Lipoma: Can Intraosseous Cyst Changes Into Lipoma With Advancing Age? J Comput Assist Tomogr 2022; 46:434-439. [DOI: 10.1097/rct.0000000000001278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mutluoglu M, Cruyt L, Thomas R, De Smet K. Atypical presentation of subchondral cysts in the femoral head. BMJ Case Rep 2021; 14:e246098. [PMID: 34848418 PMCID: PMC8634229 DOI: 10.1136/bcr-2021-246098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2021] [Indexed: 11/03/2022] Open
Affiliation(s)
| | - Ludovic Cruyt
- Department of Radiology, AZ Delta vzw, Roeselare, Belgium
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Malghem J, Lecouvet F, Omoumi P, Vande Berg B. Intraosseous lipomas originating from simple bone cysts. Skeletal Radiol 2021; 50:2129. [PMID: 34100988 DOI: 10.1007/s00256-021-03834-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/10/2021] [Accepted: 05/27/2021] [Indexed: 02/02/2023]
Affiliation(s)
- Jacques Malghem
- Département de Radiologie et Imagerie Médicale, UCLouvain, Brussels, Belgium.
| | - Frederic Lecouvet
- Département de Radiologie et Imagerie Médicale, UCLouvain, Brussels, Belgium
| | - Patrick Omoumi
- Service de Radiodiagnostic et Radiologie Interventionnelle, Lausanne University Hospital, Lausanne, Switzerland
| | - Bruno Vande Berg
- Département de Radiologie et Imagerie Médicale, UCLouvain, Brussels, Belgium
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Tins BJ, Berkowitz YJ, Konala P, Davies M, Cassar-Pullicino VN, Lalam R, Cool P. Intraosseous lipomas originating from simple bone cysts. Skeletal Radiol 2021; 50:801-806. [PMID: 33005976 DOI: 10.1007/s00256-020-03628-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 02/02/2023]
Abstract
PURPOSE Fatty or part-fatty intraosseous lesions are occasionally encountered while imaging the skeletal system. A number of case reports have proposed involution of calcaneal bone cysts to intraosseous lipomas, but this has never been proven. This paper sets out to prove that simple bone cysts (SBCs) can involute to fatty lesions indistinguishable from intraosseous lipomas. MATERIALS AND METHODS The pathology and PACS databases at 2 specialist orthopedic hospitals were retrospectively interrogated for all cases of intraosseous lipomas or SBCs with cross-sectional imaging follow-up for SBCs and precursor or follow-up imaging for intraosseous lipomas, in the time period from August 2007 to December 2016. For intraosseous lipoma cases, these were only included if change in imaging appearances was observed. RESULTS There was no case of change in the appearance in intraosseous lipomas. Six cases of SBC with cross-sectional imaging follow-up were identified in one participating hospital and none in the other. The 6 cases were comprised of 4 male and 2 female patients. Two were located in the proximal humerus, one in the proximal tibia, and 3 in the os calcis. All cases demonstrated filling in of the cystic lesion with fat from the periphery, in 2 cases complete filling in, and in 4 cases partial fatty conversion. CONCLUSION SBCs can heal with fatty conversion of the cystic cavity, with partly cystic remnants. It is proposed that at least part of the so-called intraosseous lipomas are healed simple bone cysts.
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Affiliation(s)
- Bernhard J Tins
- Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, Shropshire, SY10 7AQ, UK.
| | | | | | | | - Victor N Cassar-Pullicino
- Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, Shropshire, SY10 7AQ, UK
| | - Radhesh Lalam
- Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, Shropshire, SY10 7AQ, UK
| | - Paul Cool
- Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, Shropshire, SY10 7AQ, UK
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Powell GM, Turner NS, Broski SM, Ringler MD, Howe BM. Intraosseous "Lipoma" of the Calcaneus Developing in an Intraosseous Ganglion Cyst. J Radiol Case Rep 2018; 12:16-24. [PMID: 31565161 DOI: 10.3941/jrcr.v12i12.3263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Intraosseous lipomas are rare primary bone tumors, most common to the calcaneus. There are several proposed theories of the natural etiology of intraosseous lipomas; however, all lack definitive support. In this report, an 18-year-old man presented with radiologic evidence of a simple bone cyst of the calcaneus. Over a 4-year period, the patient was followed with interval magnetic resonance imaging. The cyst demonstrated progressive development of peripheral intralesional fat with final magnetic resonance imaging features characteristic of an intraosseous lipoma. To our knowledge, this is the first longitudinal study that shows gradual peripheral fat deposition within an intraosseous ganglion cyst, illustrating a potential cause of intraosseous lipomas of the calcaneus.
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Rajani AM, Kumar R, Shyam A. Huge Subchondral Cyst Communicating with Medulary Canal of Femur in OA Knee-Treated by Extension Stem and Bone Grafting. J Orthop Case Rep 2016; 4:81-4. [PMID: 27298967 PMCID: PMC4719383 DOI: 10.13107/jocr.2250-0685.175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION We report an osteoarthritic patient with huge sub-chondral cyst-like lesions in the Anterior part of distal femur. Deep and large bone defects and severe lateral laxity due to Advanced osteoarthritis was successfully treated with semi-constrained type total knee arthroplasty with long stem. CASE REPORT A 70yrs old Female was admitted in our institution diagnosed with severe bilateral Osteoarthritis. The x-rays showed bone on bone Tricompartment OA Knee with Varus Malalignment. She was posted for Single Stage Bilateral Total Knee Replacement and as planned the Left Knee Was Operated first. After exposure, Proximal Tibial, Distal Femoral Cuts and measurement of extension gaps the synovium from the anterior Femur was removed and sizing was done. The AP cut was then proceeded with. We spotted a small Osteochondral Cyst in the Anterior Femur which was curretted to remove the cystic material, which is when we realised that the cyst was large and communicating with the medulary canal. The remaining Femoral preparations was done keeping in mind the risk of iatrogenic fracture and extension Stem was used in the femur. The defect was then packed cancellous bone graft. CONCLUSION If suspected a Preoperative MRI should be done to exclude any sub-chondral cysts osteochondral defects and any surprise during surgery. Usually one should keep extension stems ready for difficult cases. Operating surgeon should know his implants very well, as in many standard implants extension stems can only be used when distal femur cuts are taken accordingly as 5° Valgus. Mini incision should be avoided because it may fail to reveal such surprises and may land into periprosthetic fractures.
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Affiliation(s)
- Amyn M Rajani
- Orthopaedic Arthroscopy Knee & Shoulder Clinic, 1 Court House, Opp St Xaviers School, Dhobhi Talao, Mumbai 400002. India
| | - Ritesh Kumar
- Orthopaedic Arthroscopy Knee & Shoulder Clinic, 1 Court House, Opp St Xaviers School, Dhobhi Talao, Mumbai 400002. India
| | - Ashok Shyam
- Orthopaedic Arthroscopy Knee & Shoulder Clinic, 1 Court House, Opp St Xaviers School, Dhobhi Talao, Mumbai 400002. India
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Silva FD, Pinheiro L, Cristofano C, de Oliveira Schiavon JL, Lederman HM. Magnetic Resonance Imaging in Pediatric Bone Tumors. CURRENT RADIOLOGY REPORTS 2014. [DOI: 10.1007/s40134-014-0077-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Abstract
PURPOSE Different treatment modalities have been utilized to treat unicameral bone cyst (UBC), but evidence has not been fully described to support one treatment over another and the optimal treatment is controversial. The aim of this quantitative systematic review was to assess the effectiveness of different UBC treatment modalities. METHODS We utilized Pubmed to isolate retrospective studies on patients with UBC who received any kind of treatment. The included studies needed to have a minimum sample size of 15 patients, and have provided data on radiographic healing outcome. RESULTS Sixty-two articles were selected for the meta-analysis from a total of 463 articles. The cumulative sample size was 3,211 patients with 3,217 UBC, and male to female ratio was 2.2:1. The summary or pool estimate of methylprednisolone acetate (MPA) injection resulted in a healing rate of (77.4 %) that was comparable to bone marrow injection (77.9 %). A higher healing rate was observed with MPA injection when inner wall disruption was performed. The pool estimate of bone marrow with demineralized bone matrix injection was high (98.7 %). UBC healing rate after surgical curettage was comparable whether autograft or allograft was utilized (90 %). UBC treatment with flexible intramedullary nails without curettage provided almost 100% healing rate, while continuous decompression with cannulated screws provided 89 % healing rate. Conservative treatment indicated a healing rate of 64.2, 95 % CI (26.7-101.8). CONCLUSIONS Active treatment for UBC provided variable healing rates and the outcomes were favorable relative to conservative treatment. Due to the heterogeneity of the studies and reporting bias, the interpretation of these findings should be handled with caution.
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Abstract
After initial evaluation with radiography, magnetic resonance (MR) imaging is the most common modality used to establish the diagnosis and characterize osseous and soft tissue tumors of the hip. Tumors involving the proximal femur are often benign, and MR imaging can be specific in diagnosing solitary bone cyst, osteochondroma, and chondroblastoma. Benign and malignant soft tissue tumors about the hip are often nonspecific in their MR imaging appearances, but knowledge of the patient's age may direct a more limited differential diagnosis. In the setting of malignancy, MR imaging is commonly used to stage tumors and follow patients postoperatively.
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Minoda M, Matsumoto T, Kubo S, Matsushita T, Takayama K, Morinaga Y, Kurosaka M, Kuroda R. Multiple huge subchondral cysts associated with pseudogout in the bilateral knees: a case report and review of the literatures. J Orthop Sci 2012; 17:817-21. [PMID: 21748236 PMCID: PMC3513598 DOI: 10.1007/s00776-011-0110-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2010] [Accepted: 05/31/2011] [Indexed: 11/24/2022]
Affiliation(s)
- Masaya Minoda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan
| | - Tomoyuki Matsumoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan
| | - Seiji Kubo
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan
| | - Takehiko Matsushita
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan
| | - Koji Takayama
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan
| | - Yukiko Morinaga
- Department of Diagnostic Pathology, Kobe University Hospital, Kobe, Japan
| | - Masahiro Kurosaka
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan
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Kransdorf MJ, Peterson JJ, Bancroft LW. MR Imaging of the Knee: Incidental Osseous Lesions. Radiol Clin North Am 2007; 45:943-54, v. [DOI: 10.1016/j.rcl.2007.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Kransdorf MJ, Peterson JJ, Bancroft LW. MR imaging of the knee: incidental osseous lesions. Magn Reson Imaging Clin N Am 2007; 15:13-24. [PMID: 17499178 DOI: 10.1016/j.mric.2007.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The knee joint remains the articulation most frequently assessed by MR imaging, and osseous tumor and tumor-like lesions are not uncommon incidental imaging findings. This article reviews the most commonly encountered incidental lesions, emphasizing the characteristic MR imaging features. It is intended not as a complete review of the imaging findings associated with these lesions but as a summary, highlighting the MR imaging features that are most useful in suggesting a specific diagnosis. The authors organize incidental lesions into the following broad categories: cartilaginous, fibro-osseous, and degenerative. They do not address those lesions that are typically symptomatic and, as a result, likely to be directly related to the patients' clinical presentation and subsequent imaging.
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Lee SJ, Yoon JH, Bae JI, Eun CK, Choi JA, Suh KJ, Seo SS, Ha DJ. Intracortical lipoma of the femur. Skeletal Radiol 2007; 36 Suppl 1:S77-81. [PMID: 17072659 DOI: 10.1007/s00256-006-0205-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2005] [Revised: 09/12/2005] [Accepted: 09/12/2005] [Indexed: 02/02/2023]
Abstract
Intracortical lipoma is an extremely rare benign primary bone tumor. We encountered a case of an intracortical lipoma found incidentally in the femur of a 31-year-old female. Magnetic resonance imaging and computed tomography of the femur demonstrated an intracortical fatty lesion in the posterolateral aspect of the diaphysis. The intracortical lesion showed some intramedullary extension, multiple septations, and dot-like calcifications. Intralesional curettage was performed. Histologically, the tumor consisted of mature, viable adipocytes without foci of fat necrosis or dystrophic calcification.
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Affiliation(s)
- Sun-Joo Lee
- Department of Radiology, College of Medicine, Inje University, Busan Paik Hospital, 633-165 Kegum-dong, Busanjin-ku, Busan 614-735, South Korea.
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Alyas F, James SL, Davies AM, Saifuddin A. The role of MR imaging in the diagnostic characterisation of appendicular bone tumours and tumour-like conditions. Eur Radiol 2007; 17:2675-86. [PMID: 17342487 DOI: 10.1007/s00330-007-0597-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2006] [Revised: 12/02/2006] [Accepted: 01/15/2007] [Indexed: 12/14/2022]
Abstract
MRI has an established role in the local staging of primary bone tumours. However, as the majority of tumours have non-specific appearances on MRI, the diagnosis is usually established on the basis of clinical history, plain film findings and biopsy. This article reviews the value of MRI in the further characterisation of appendicular bone tumours and tumour-like lesions, with particular reference to peri-lesional oedema, fluid-fluid levels, flow voids, fat signal, cartilage signal and dedifferentiation. These features are a useful adjunct for distinguishing between benign and malignant disease, pointing towards a more specific diagnosis, and guiding biopsy.
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Affiliation(s)
- F Alyas
- Department of Radiology, The Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK
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