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Simple bone cysts: better with age?

Sandra Donaldson1, James G Wright

  • 1*Department of Surgery, The Hospital for Sick Children †Department of Surgery, Division of Orthopaedic Surgery ‡Departments of Public Health Sciences, and Health Policy, Management and Evaluations, University of Toronto, Toronto, ON, Canada.

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Summary
This summary is machine-generated.

Simple bone cysts (SBC) often do not resolve with skeletal maturity. This study found no complete healing in patients even with closed growth plates, suggesting further research is needed.

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Area of Science:

  • Orthopedics
  • Pediatric Orthopedics
  • Radiology

Background:

  • Simple bone cysts (SBC) are common benign bone lesions in children and adolescents.
  • It is widely assumed that SBCs resolve spontaneously with skeletal maturity.

Purpose of the Study:

  • To evaluate the natural resolution of simple bone cysts (SBC) with age.
  • To determine if skeletal maturity, indicated by growth plate closure, correlates with SBC healing.

Main Methods:

  • Twenty-four subjects with SBC, previously enrolled in a clinical trial, were reassessed for cyst healing.
  • Clinical data (pain, function) and radiographic parameters (cyst area, endosteal thickening, growth plate status) were analyzed.
  • Cyst healing was graded, with complete healing defined as Grade 4 (obliteration of the cyst).

Main Results:

  • None of the 24 subjects achieved complete cyst healing (Grade 4) at follow-up.
  • While 87% of patients had closed growth plates, cyst area reduction was not significant.
  • Decreased loculation and increased endosteal thickening were the only significant radiographic changes observed.

Conclusions:

  • Skeletal maturity and closed growth plates do not guarantee the healing of simple bone cysts.
  • Simple bone cysts may persist into early adulthood, despite minimal symptoms or fractures.
  • Further longitudinal studies are necessary to understand the long-term behavior of SBCs into adulthood.