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Post-traumatic cortical cysts in paediatric fractures: is it a concern for emergency doctors? A report of three cases
Shirzad Houshian1, Niels Wisbech Pedersen, Trine Torfing
1Department of Orthopaedics, University Hospital Lewisham, London, UK.
Insights
Post-traumatic cortical bone cysts are rare in children, often mistaken for tumors. This study reviews their occurrence, pathogenesis, and presentation, including a unique femur case.
Area of Science:
- Pediatric Orthopedics
- Pediatric Radiology
- Pediatric Bone Pathology
Background:
- Post-traumatic cortical bone cysts are uncommon pediatric bone lesions.
- Typically associated with greenstick fractures of the distal radius.
Observation:
- Three pediatric cases presented to a fracture clinic with suspected bone tumors.
- One unique case involved a cystic lesion in the femur following a displaced fracture.
- Radiographs revealed oval radiolucencies proximal to fracture sites.
Findings:
- These lesions can mimic bone infections or tumors, causing diagnostic challenges.
- The pathogenesis involves post-traumatic bone remodeling and intraosseous pressure changes.
- A femur cyst following a displaced fracture represents a novel presentation.
Implications:
- Increased awareness of post-traumatic cortical bone cysts is crucial for accurate pediatric fracture management.
- Distinguishing these benign lesions from aggressive bone pathologies avoids unnecessary interventions.
- Further research into the pathogenesis can refine diagnostic and treatment strategies.
Abstract:
Post-traumatic cortical bone cyst is a rare occurrence in children. It is typically located in the distal radius, as a result of greenstick fracture. We report three cases referred to our fracture clinic as a tumour in bones. In one of our cases, the cystic lesion was noted following a displaced fracture in the femur, which is not previously published in the literature. The cyst-like lesion appeared as an oval radiolucency proximal to the previous fracture site on radiograph films. These lesions can cause concern for the on-call teams as they can mimic an infection or a tumour of the bone. We highlight the pathogenesis of the lesion with a review of the literature.
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