Aneurysmal bone cyst in a female collegiate field hockey player: a case report

To present the case of an intercollegiate field hockey player with an aneurysmal bone cyst of the femur and the clinical decision making necessary in the evaluation, management, surgical intervention, and positive outcome of this athlete.

A 21-year-old field hockey player presented with signs and symptoms typical of a deep thigh contusion. She had no history of direct or indirect trauma, infection, or previous injury.

Aneurysm, bone cyst, chondroma, giant cell tumor, osteochondroma, osteosarcoma, osteoid osteoma.

When her symptoms persisted beyond 6 months despite conservative care, she underwent radiographs, magnetic resonance imaging, and bone scan, which revealed a lesion in the right femur. At surgery, the lesion was diagnosed as an aneurysmal bone cyst, and it was excised by an incisional x-ray-guided biopsy followed by curettage and bone grafting.

The aneurysmal bone cyst presented as a typical thigh strain or deep contusion during the athlete's training and conditioning season. After all forms of conservative management proved ineffective, the athlete was referred to her physician. A detailed history and physical examination demonstrated no underlying musculoskeletal pathology coinciding with the athlete's symptoms.

Increased clinical awareness is necessary when conservative management fails to resolve an athletic injury in an appropriate length of time. Proper diagnostic tools are essential in determining the pathology of the injury and whether surgical intervention is needed.