Pediatric patient with upper humerus lytic lesion with coical thinning, which among the following is not a treatment modality:
High-Yield Explanation
CYSTIC LESIONS OF BONE Unicameral Bone Cyst: True Cyst Most common in the proximal humerus and femur. The lesions are most active during skeletal growth and usually heal spontaneously at maturity. Asymptomatic Radiographs: Centrally located, purely lytic lesion with a well-marginated outline. Thinned coical fragment fractures and falls into the base of the lesion confirming its empty cystic nature. Fallen fragment sign is pathognomonic of a unicameral bone cyst, bone fragment, may also hinge around and move with fluid called as trap door sign. Unicameral bone cysts are classified as Active: when they are within 1 cm of the physis Latent: when they are closer to the diaphysis. Rx: Small, asymptomatic lesions in the upper extremities can be treated with observation with serial plain radiographs. Larger lesions (lesions at risk for pathological fracture), symptomatic lesions, and lesions in the lower extremities usually are treated with : Curettage (with or without bone grafting or internal fixation) Aspiration and injection (steroids, bone marrow aspirate, demineralized bone matrix, or sclerosant). Figs: (A) Unicameral or simple bone cyst (B) Fallen fragment (leaf) sign