Aneurysmal bone cystUnicameral bone cystGiant cell tumour

Biopsy proven aneurysmal bone cyst

Presently 3 months post biopsy

1. Currettage and allow spontaneous healing

2. Currettage and bone grafting3. Currettage and cryotherapy4. Radiotherapy5. Intralesional injection steroid,

calcitonin6. Embolisation of feeding vessel7. Sclerotherpy

J Bone Joint Surg [Br]2006;88-B:1212-16.

Percutaneous sclerotherapy has emerged as an excellent method of treatment.

Hydroxypolyaethoxydodecan is a sclerosing agent.

It has been sucessfully used in the treatment of AV malformations of

1.GI tract2.varicose veins3.Telengiectases, varicose veins

Sample size = 72Male= 46, female= 26Mean age= 15.639 lesions – upper limb 29 lesions - lower limb 4 lesions - axial skeletonMean follow up 34 months ( 2yrs &

10 months)

All pts underwent biopsy confirmation

Treatment 3 months after biopsy ( giving time for spontaneous healing)

Preop volume of the lesion was calculated

< 15 yrs GA, > 15 yrs local

16 gu needle or bone marrow needle used.

Under C arm guidance

1 ml for 1cm3 volume

Lock the needle for 1 min so that no back

flow

No more than 10 ml was given

• Follow up1.6 weeks2.12 weeks3.6 months there after

1. Time at which the pain had resolved.

2. The cortical thickness of the wall of

the cyst had started reforming.

3. Lesion had stopped growing in size.

2nd injection was given if any of the

above criteria were not met.

grade I (< 25% of the initial lesion)

66%

grade II (25% to 49%) 30.5%

grade III (50% to 74%) 2.8%

grade IV (75% or more).

97% success at the end of final follow up

Recurrence 2 cases Induration at the site of injection 18

cases, hypopigmentation 3 cases, local inflammatory reaction,episode of dizziness

hypopigmentation,

necrosis at the site of the injection in

the case of extravasation,

pulmonary embolism,

osteomyelitis,

allergic reactions

This series had only hypopigmentation

skin conditions at the site of injection,

heart disease,asthma pregnancy