Disease is one of the most unpleasant phenomena that can happen in our life or the life of our loved ones. And sooner or later, everyone is faced with some kind of ailment that affects one or another organ or system of the body. That is why it is so important to pay attention to yourself and undergo examinations from time to time to be sure that you are healthy or diagnose diseases on time.
Human skeleton
Our whole body supports the skeleton, which consists of 207 bones. People with bone diseases know from their own experience how painful the consequences of these ailments can be, and they do not always manifest themselves in the first stages. Whatever the disease, it must be treated so that it does not progress and does not give complications. Bone cyst refers to tumor diseases, fluid is localized in the cavity of the bones. At this point, blood circulation is disturbed, and pathogenic substances destroy the structure of the tissue.
Varieties of the disease. Aneurysmal cyst
Cysts are divided into two types, and each of them has its own specifics. There is a solitary and aneurysmal bone cyst. The latter are more common in adolescent girls aged 10 to 15 years. Most often, the bones of the pelvis and spine suffer from damage, pathology can occur after an injury. The affected area is swollen and painful; upon examination, the doctor may see dilated saphenous veins, this place is hot to the touch compared to other parts of the body.
If the lower limbs are affected by the disease, then the support is impaired, and the patient’s gait can also change. Very often, joint contracture develops, which is closest to the formation. When the disease affects the bones of the vertebra, neurological disorders occur, this is due to the fact that the spinal roots are compressed.
Forms and phases of the course of the disease
Two forms of aneurysmal bone cyst are distinguished: eccentric and central. There are also phases, each of which has its own manifestations. In the osteolysis phase, the disease is at its peak; during this period, an x-ray can be seen that has no structure. The focus has an intraosseous and extraosseous component. The periosteum is preserved. Further, delimitation occurs, and the area inside the bone is separated from the healthy bone, and between them a site forms - sclerosis. The extraosseous zone becomes denser and smaller in size.
Gradual attenuation comes in the reduction phase, and in the recovery phase we can say that the person is healthy, but in the pictures you can still see the residual cavity - hyperostosis.
Tumor-like bone lesion
Bone damage can be different, but it is the aneurysmal bone cyst that refers to tumor-like, albeit benign formations. Its etiology is not clear and consists of numerous spaces that are filled with blood. Most often they are diagnosed in adolescents and children. Patients under 20 years old are at risk for this disease, it is 80% of patients that fall into this age category.
The clinical picture does not always manifest itself vividly, and a disease is diagnosed only when the patient goes to the hospital with a fracture. During examinations, all laboratory tests do not go beyond the norm.
Tumor locations
A bone cyst is a pathology and consists of vascular spaces filled with blood. These spaces of different sizes can be filled with a liquid similar to blood serum, they are separated by connective tissue septa. An accurate diagnosis is made using an x-ray. In this case, it makes no sense to conduct a biopsy, because this procedure has no diagnostic value and receives only fresh blood in the aspirate.
In the vast majority of cases, ACC is the primary lesion and is not the result of a concomitant disease, but in rare cases it may be associated with any pathological processes. Cysts can be found in the tubular bones of the lower and upper extremities.
Children and adolescents most often suffer from the disease due to the fact that the focus is localized precisely in the non-closed growth zones of long tubular bones, namely in the metaphyses.
The defeat of the tubular bones occurs in 60% of all cases of diseases, of which 40% are bones of the lower extremities. Bone cyst of the tibia and fibula is found in about 24%. The femur is affected in 13% of cases.
The upper limbs are affected a little less often, in a percentage ratio they account for 20%, the spine and sacrum - up to 30% with frequent transition to the body of the spine and its posterior elements.
Similar cysts are found in the bones of the skull. No matter where the education appears, it can and should be treated, and the sooner it can be diagnosed, the better.
Diagnostic procedures
The most effective diagnostic methods for this disease are computed tomography and radiography. A bone cyst is a clearly delimited lesion with sclerotic edges. On CT, all changes, violation of the cortical layer and how much the lesion spread to the soft tissues are clearly visible. On CT, you can detect fluid levels, with MRI it is somewhat more difficult to identify them, but such a diagnosis is also carried out.
With aneurysmal bone cysts, fluid is a characteristic feature, but this should not be guided only, because the presence of fluid in the bone tissue can be a signal for other benign as well as malignant lesions. The fluid collects in the bone with osteosarcoma, a giant cell tumor, chondroblastoma and a simple bone cyst.
The reason for the development of the disease
To prevent any disease or its relapse, it is important to know the cause of its occurrence. In this case, the pathology develops due to the fact that insufficient blood flows to the body due to some circumstances. For this reason, this site does not fully receive the minerals and vitamins that are necessary for normal functioning. Oxygen does not enter in the required volume, and tissue destruction occurs. In this place a cyst forms.
There are a number of reasons that contribute to the development of the disease, but they are not an absolute guarantee that it will develop.
Chronic bone defects, bone degeneration and trauma - all this can cause the patient to have additional health problems. But, besides this, anomalies of intrauterine development are also possible, which do not go anywhere with the birth of a child. If the mother led an unhealthy lifestyle during pregnancy, the child can receive a bone cyst "as a gift" from her mother.
Bone cyst and mechanism of its development
It all starts with the fact that blood circulation is disturbed in a limited area of ​​the bone. Oxygen intake and nutrition are disrupted, and this site begins to break down, lysosomal enzymes that break down collagen, glycosaminoglycans and other proteins are activated. A cavity filled with a liquid is formed, in which high osmotic and hydrostatic pressure. Due to this pressure and a large number of enzymes in the fluid, the destruction of the bone around the cyst of bone tissue begins. The period of the disease can last up to two years, with a favorable outcome for this period, the fluid pressure should decrease and the activity of enzymes should decrease. The active phase of the disease is replaced by a passive one, and over time, the cyst disappears, and new bone tissue replaces the affected areas.
The recovery period occurs in the second year of the course of the disease, an x-ray is taken at the end of treatment to make sure that the person is healthy.
How is the treatment carried out?
After the cyst is diagnosed, it is recommended to unload the limb with the affected bone. If a fracture occurred in this place, then a gypsum is applied for a period of 6 weeks.
Treatment of bone cysts is carried out by conservative methods. Using intraosseous anesthesia needles, the contents of the cavity are removed. To reduce the pressure inside the cyst, produce numerous perforations of the walls. Next, the cleavage products and enzymes are removed from the cavity, washing with distilled water or saline is done. To neutralize fibrinolysis, the cavity is washed with a solution of aminocaproic acid. At the end of the procedure, aprotinin is administered. For adult children over 12 years of age and with large cysts, hydrocortisone and triamcinolone can be administered.
The frequency of the procedure in the treatment of active cysts is about once a month, if the cyst closes, then the frequency can be about 1 time in a month and a half. For the entire period of treatment, from 6 to 10 punctures are performed.
The entire course of treatment is accompanied by x-ray control. When the first signs of a decrease in education are observed, the patient is sent to exercise therapy.
If conservative treatment does not give the desired result, or if the formation is in an inconvenient place and there is a threat of compression of the spinal cord or the risk that bone destruction will be significant, then this is an indication for removal of the bone cyst by surgical intervention.
An edge resection of the affected area with alloplasty of the defect is performed. Carrying out operations in the active phase is very risky, they are done only in extreme cases. There is a chance to hook the sprout zone and damage it, and this can lead to the fact that the limb in the distant period will lag behind in growth. In addition, relapses are possible with contact between the cyst and the growth zone on the bone.
So, the main directions in conservative treatment are immobilization, puncture and injection of drugs into the cyst cavity. Physiotherapy and exercise therapy are prescribed. When there is no effect from conservative treatment, then resection and subsequent alloplasty are done.
What is the danger of this disease?
It is very important to go from the onset of the disease to full recovery, and in the future not to have any problems in this area. If the child was diagnosed with a bone cyst of the humerus, then I want to know how much this will affect my future life. With such diagnoses, one can count on a favorable outcome and a good prognosis. After reducing the cavity, the patient recovers and is in no way limited in his ability to work.
The consequences can be distant in time and are due to the fact that contractures were formed as a result of the disease, massive destruction of bone tissue was discovered, in which the limb was deformed. But if the recommendations of the doctors were followed and adequate timely treatment was carried out, then such an outcome is very rare.
Solitary cyst
It is worth saying in more detail about this variety of cysts. Boys often suffer from it, adults rarely hear such a diagnosis, usually these are residual effects after an undiagnosed illness transferred in childhood. The bone cyst of the femur and humerus occupy the first place here. In the early stages, there are no symptoms. The patient may notice minor pain and swelling. Depending on the location of the lesion, lameness may appear.
Sometimes a diagnosis is made only at the time of going to the hospital with a fracture. At this point, the tissue becomes thinner and even with a minor injury, a fracture occurs. Locally, when examined, these places are not expressed in any way, there is neither edema, nor hyperemia. The skin is not pronounced venous pattern. Only with palpation can one feel a thickening with bone density. If the cyst is large, then its wall can bend when pressed. When there is no fracture, then the movement and support are fully preserved. Here, the same stages of the course of the disease are observed as in the case of an aneurysmal cyst. Strength at the site of the hollow bone is reduced, pathological fractures can occur here.
At the last stages, a complete recovery is observed, a small cavity or a limited area of ​​osteosclerosis may remain.
Symptoms observed with such a disease
Not necessarily all the symptoms described below indicate that the patient has a cyst, but if it has formed, the patient may have such manifestations.
In the first stages, there are no signs at all. Much later, edema and seals appear in the affected areas. Pain during this period does not attract much attention and does not cause discomfort. The formation of the contour of the secondary joint. Bone cyst of the tibia, reaching large sizes, can give lameness and discomfort when moving. Often the first symptom with which it is possible to diagnose the disease is a fracture.
If the cyst was formed in the femur, then the patient may feel pain in the hip joint, as a result, you can dislocate the leg, break the femoral neck and limp on the leg. If the problem occurs in the bones of the spine, the teenager may feel dizzy, headaches and tinnitus. The work of the bladder and intestines is disturbed. There is paresis of the upper and lower extremities. Education in the calcaneus is not accompanied by any symptoms.
After diagnosis, a conservative treatment or surgery for a bone cyst is performed. It is impossible to leave the disease unattended, because additional complications arise.
Possible complications without treatment
In the rarest cases, a cyst does not need treatment. The disease goes away by itself, and an adult can only accidentally reveal during the examination after years that he has a cavity in the bone. But if the disease was diagnosed, then you should not hope that everything will pass by itself. A negligent attitude to health can lead to bone destruction, degeneration into a malignant tumor and deformation of the limb.
After a full recovery, relapses are possible, in order to avoid this, you need to eat right, be extremely careful and avoid injuries, lead a healthy lifestyle and, of course, undergo preventive examinations from time to time. In 95% of cases, the outcome of this disease is favorable, which cannot but rejoice.
Tooth cyst
Education can appear not only in the tubular bones. The cyst in the bone tissue of the tooth is also diagnosed. Inflammation and maturation of the granule occurs. This is a defensive reaction to an injury or infection.
The formation looks like a bubble, which can reach several centimeters in diameter. It is filled with pus or fluid.
A cyst appears due to the development of an infection in the tooth canal. The cause may be an injury or a chronic disease of the nasopharynx and oral cavity.
Periodontitis or periodontitis can provoke the disease. If a child has low immunity or caries, a cyst may also develop. There are much more prerequisites for a tooth cyst than for the development of other types of cysts. Even poor-quality installation of a crown or seal can provoke such a development of the disease. The difficult stage of teething wisdom also causes this disease.
Symptoms of a tooth cyst
Like all other types of cysts, in the first stages it is very difficult to diagnose. Darkening of the tooth and discomfort when chewing solid food are overlooked by many. Pain can occur only when the granule is about 1 centimeter in size. Here the signs become very bright and pronounced, it may seem that the problem arose instantly and out of the blue.
In the area of ​​inflammation, pain is felt, swelling on the face. Lymph nodes increase in size and become painful. If the cyst is located in the maxillary sinuses, then a headache appears and the temperature rises.
To save the child from these problems, you have to perform an operation and remove the cyst along with the tooth. It is necessary to consult a doctor, only he can determine if it is a granuloma or a cyst. There is a significant difference between them, because granuloma is often quite therapeutically treated, and a cyst requires radical measures.
The cyst can be on the root of the tooth, and on the gum, found in the maxillary sinus or under the crown of the tooth. Often parents bring their child to the dentist for examination with complaints of toothache, but after the picture is taken, the cause of the pain becomes clear. The dentist does not deal with this issue, he gives a referral to a surgeon who is already conducting an operation to remove the tumor.