Pediatric Musculoskeletal Radiology

Ultrasound Guided Procedures and Radiologic Imaging for Pediatric Anesthesiologists ◽

10.1093/med/9780190081416.003.0014 ◽

2021 ◽

pp. 155-180

Author(s):

Nicholas Florence

Keyword(s):

Developmental Disorders ◽

Eosinophilic Granuloma ◽

Slipped Capital Femoral Epiphysis ◽

Knee Injuries ◽

Developmental Dysplasia ◽

Foot Deformities ◽

Bone Cysts ◽

Musculoskeletal Radiology ◽

Aneurysmal Bone Cysts ◽

Infection And Inflammation

Chapter 14 examines radiologic images for common and uncommon pediatric musculoskeletal disorders. These include pediatric fractures such as buckle fractures; bowing and greenstick fractures; growth plate, stress, and elbow fractures; avulsion injuries of the pelvis and hip; knee injuries; and nonaccidental trauma. The chapter goes on to look at infection and inflammation, including osteomyelitis, septic arthritis, transient synovitis, and juvenile idiopathic arthritis. Congenital and developmental disorders covered include developmental dysplasia of the hip, slipped capital femoral epiphysis, Legg-Calvé-Perthes disease, Blount disease, congenital foot deformities, scoliosis, neurofibromatosis, osteogenesis imperfecta, osteopetrosis, and dwarfism. Metabolic disorders include rickets, scurvy, lead poisoning, Gaucher disease, and mucopolysaccharidoses. Neoplastic and other aggressive lesions include osteosarcoma, Ewing sarcoma, osteoid osteoma, eosinophilic granuloma, osteochondroma, enchondroma, nonossifying fibromas/fibrous cortical defects, fibrous dysplasia, aneurysmal bone cysts, and unicameral (simple) bone cysts.

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Primary atlantoaxial bone tumors in children: management strategies and long-term follow-up

Journal of Neurosurgery Pediatrics ◽

10.3171/2013.11.peds13245 ◽

2014 ◽

Vol 13 (3) ◽

pp. 260-272 ◽

Cited By ~ 17

Author(s):

Arnold H. Menezes ◽

Raheel Ahmed

Keyword(s):

Fibrous Dysplasia ◽

Needle Biopsy ◽

Bone Tumors ◽

Ewing’S Sarcoma ◽

Ewing's Sarcoma ◽

Eosinophilic Granuloma ◽

Bone Cysts ◽

Aneurysmal Bone Cysts

Object Atlantoaxial tumors account for a substantial proportion of primary bone tumors in children. Before resection, surgeons must consider the complex regional anatomy, the potential for neurological compromise, craniocervical instability, and the question of tumor resectability in a growing spine. Using current technology, the authors analyzed surgical cases in this light and present outcomes and treatment recommendations after long-term patient follow-up. Methods: The authors reviewed clinical records for 23 children whose primary atlantoaxial bone tumors were treated from 1996 through 2010. Results Pathological lesions among the 23 patients were 4 aneurysmal bone cysts, 2 osteochondromas, 5 chordomas, 4 osteoblastomas, 3 fibrous dysplasias, 4 eosinophilic granulomas, and 1 Ewing's sarcoma. Clinical presentation consisted of neck pain (n = 23), headaches and occipital pain (n = 16), myelopathy (n = 8), and torticollis (n = 4). Selective angiography and coil embolization were undertaken for all patients with aneurysmal bone cysts and osteoblastomas, 2 patients with chordomas, 1 patient with fibrous dysplasia, and 1 patient with Ewing's sarcoma. Primary embolization treatment of radiation-induced aneurysmal bone cyst of the atlas showed complete reossification. Results of CT-guided needle biopsy were diagnostic for 1 patient with eosinophilic granuloma and 1 with Ewing's sarcoma. Needle biopsies performed before referral were associated with extreme blood loss for 1 patient and misdiagnosis for 2 patients. Surgery involved lateral extrapharyngeal, transoral, posterior, and posterolateral approaches with vertebral artery rerouting. Complete resection was possible for 9 patients (2 with osteochondroma, 3 with fibrous dysplasia, 2 with chordoma, and 2 with osteoblastoma). Decompression and internal fusion were performed for 3 patients with aneurysmal bone cysts. Of the 23 patients, 7 underwent dorsal fusion and 4 underwent ventral fusion of the axis body. Chemotherapy was necessary for the patients with eosinophilic granuloma with multifocal disease and for the patient with Ewing's sarcoma. There was no morbidity, and there were no deaths. All patients with benign lesions were free of disease at the time of the follow-up visit (mean ± SD follow-up 8.8 ± 1.1 years; range 2–18 years). Chordomas received proton or LINAC irradiation, and as of 4–15 years of follow-up, no recurrence has been noted. Conclusions Because most atlantoaxial tumors in children are benign, an intralesional procedure could suffice. Vascular control and staged resection are critical. Ventral transoral fusion or lateral extrapharyngeal fusion has been successful. Resection with ventral fusion and reconstruction are essential for vertebral body collapse. Management of eosinophilic granulomas must be individualized and might require diagnosis through needle biopsy.

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Percutaneous sclerotherapy of spinal aneurysmal bone cysts causing neurological compromise: preliminary experience with a novel technique

10.26226/morressier.5ee7788d8ba89b7c87c300b1 ◽

2020 ◽

Author(s):

Danoob Dalili

Keyword(s):

Bone Cysts ◽

Novel Technique ◽

Percutaneous Sclerotherapy ◽

Aneurysmal Bone Cysts

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Cervical Spine Aneurysmal Bone Cysts: A Meta-Analysis of 114 Cases and Comparison of Clinical Features between Pediatric and Adult Patients

The Spine Scholar ◽

10.26632/ss.4.2017.1.1 ◽

2017 ◽

Vol 1 (1) ◽

pp. 21-29

Author(s):

Matthew Protas ◽

Henry Wingfield ◽

Basem Ishak ◽

Rong Li ◽

Rod J. Oskouian ◽

...

Keyword(s):

Cervical Spine ◽

Clinical Features ◽

Meta Analysis ◽

Adult Patients ◽

Bone Cysts ◽

Aneurysmal Bone Cysts

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Two cases of paralysis secondary to aneurysmal bone cysts with complete neurologic recovery

Spine Deformity ◽

10.1007/s43390-019-00023-1 ◽

2020 ◽

Vol 8 (2) ◽

pp. 339-344

Author(s):

Aaron Beck ◽

David L. Skaggs ◽

Tracy Kovach ◽

Erin Kiehna ◽

Lindsay M. Andras

Keyword(s):

Bone Cysts ◽

Neurologic Recovery ◽

Aneurysmal Bone Cysts

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Aneurysmal Bone Cysts Recur at Juxtaphyseal Locations in Skeletally Immature Patients

Clinical Orthopaedics and Related Research ◽

10.1007/s11999-007-0080-8 ◽

2008 ◽

Vol 466 (3) ◽

pp. 722-728 ◽

Cited By ~ 40

Author(s):

Patrick P. Lin ◽

Christopher Brown ◽

A. Kevin Raymond ◽

Michael T. Deavers ◽

Alan W. Yasko

Keyword(s):

Bone Cysts ◽

Skeletally Immature ◽

Aneurysmal Bone Cysts

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Aneurysmal Bone Cyst: A Review of 150 Patients

Journal of Clinical Oncology ◽

10.1200/jco.2005.15.255 ◽

2005 ◽

Vol 23 (27) ◽

pp. 6756-6762 ◽

Cited By ~ 222

Author(s):

Henry J. Mankin ◽

Francis J. Hornicek ◽

Eduardo Ortiz-Cruz ◽

Jorge Villafuerte ◽

Mark C. Gebhardt

Keyword(s):

Aneurysmal Bone Cyst ◽

Local Recurrence Rate ◽

Bone Cyst ◽

Secondary Development ◽

Bone Cysts ◽

Resonance Imaging ◽

Imaging Studies ◽

Treatment Protocols ◽

Imaging Appearance ◽

Aneurysmal Bone Cysts

PurposeWe have reviewed a series of 150 aneurysmal bone cysts treated over the last 20 years.Patients and MethodsThe lesions were principally located in the tibia, femur, pelvis, humerus, and spine and, in most cases, presented the imaging appearance originally described by Jaffe and Lichtenstein as a blowout with thin cortices.ResultsOnly one of the patients was believed to have an osteoblastoma of the spine with secondary development of an aneurysmal bone cyst, and none of the patients developed additional lesions. The patients were treated primarily with curettage and implantation of allograft chips or polymethylmethacrylate, but some patients were treated with insertion of autografts or allografts. The local recurrence rate was 20%, which is consistent with that reported by other centers.ConclusionAneurysmal bone cysts are enigmatic lesions of unknown cause and presentation and are difficult to distinguish from other lesions. Overall, the treatment is satisfactory, but it is possible that newer approaches, such as improved magnetic resonance imaging studies, may help diagnose the lesions and allow the physicians to plan for more effective treatment protocols.

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