Related Experiment Videos
[Essential bone cyst of the calcaneus in children. Report of three cases]
L M Antón Rodrigálvarez1, L Ortega Medina, M I Cabadas González
1Unidad de Ortopedia Infantil, Hospital Clínico San Carlos, Madrid.
Insights
Essential bone cysts in the calcaneus are rare in children, often symptomatic, and less responsive to steroid treatment compared to other locations or adult cases. Surgery is indicated for persistent pain or atypical imaging.
Area of Science:
- Pediatric Orthopedics
- Skeletal Pathology
- Bone Lesions
Background:
- Essential bone cysts (EBCs) are benign bone lesions, with calcaneal involvement being uncommon in pediatric populations.
- Understanding the unique characteristics of EBCs in the calcaneus is crucial for effective management in children.
Purpose of the Study:
- To analyze the properties and evolution of essential bone cysts of the calcaneus in children.
- To compare pediatric calcaneal EBCs with those found in adult patients.
Main Methods:
- Retrospective review of pediatric cases diagnosed with calcaneal EBC over 16 years.
- Evaluation of clinical, radiological, and histological data.
- Assessment of treatment outcomes for intracavitary steroid injections and curettage with bone grafting.
Main Results:
- The mean age of pediatric patients was 10.3 years.
- Two patients presented with recurrent heel pain exceeding six months.
- Curettage and bone grafting were performed in all cases, with steroid therapy failing in two instances.
Conclusions:
- Calcaneal EBCs are exceptionally rare in children and frequently symptomatic.
- Pediatric calcaneal EBCs demonstrate resistance to intracavitary steroid therapy, unlike other EBC sites or adult calcaneal EBCs.
- Recurrent heel pain and atypical radiographic findings are indicators for surgical intervention.
Objective:
The purpose of this study was to analyze the properties of essential bone cyst of the calcaneus in childhood, as well as its evolution, and differences with regard to adults.
Patients And Methods:
The cases of children with a diagnosis of essential bone cyst of calcaneus in last sixteen years in the pediatric orthopedic unit of San Carlos Clinic have been reviewed. We evaluated the information regarding the clinical history and the radiological and histological date as well as the therapy result with esteroid intracavity therapy and curettage and bone grafting. The radiologic score was done following Södergard criteria and the posttreatment follow-up with Neer's score.
Results:
The mean age of the patients was 10.3 years. Two of the patients had recurrent heel pain for more than six months. Treatment consisted in intracavitary esteroid in two cases and curettage and bone grafting in all three cases, in two of the cases because of failure of esteroid therapy and in the other because of an atypical X-ray image. In all cases the histological stady identified the existence of a characteristic membrane conective tissue. The postsurgery follow-up a period of half four years has been satisfactory.
Conclusions:
The essential bone cyst of the calcaneous is exceptional localization in children, frequently symptomatic and resistant to the esteroid intracavitaria contrary to what happens with the essential bone cyst of other localizations and with the essential bone cyst of the calcaneus in the adults. The recurrent heel pain and atipical X-ray image are surgery indications.