Twelve-year follow-up of a case of proximal femoral Unicameral Bone Cyst (UBC) treated by steroid injection using radiological and DXA scan data

Abstract

This report is of a proximal femoral unicameral bone cyst in a patient presented at 3 years. Intra-lesional steroid injection was used to treat this large active lesion. The response to treatment was monitored with the use of dual-energy X-ray absorptiometry (DXA) scan as an indirect method of monitoring the activity of the bone cyst. The patient had developed stress fracture during the course of treatment which had remodelled fully after successful treatment with multiple injections; at 12-year follow-up, the patient reached skeletal maturity. The affected femur had remodelled back to normal radiological appearance without avascular necrosis. This has demonstrated that steroid injection is a safe and effective procedure to achieve regression of a large active bone cyst in the proximal femur. It is a minimal invasive procedure resulting in no scar. DXA scan is a useful method combining clinical assessment to monitor status of the bone cyst to allow timing of injection. 中文摘要: 本報告為3歲患者的股骨近端骨囊腫，以用病灶內類固醇注射來治療這個巨大的活性病灶。 使用雙能X射線吸收測定法 (DXA) 掃描作為間接方法監測骨囊腫活性對治療的反應。 患者在治療過程中出現了應力性骨折，經多次注射成功治療後已完全改型，隨訪12年，患者達到骨骼成熟。 受影響的股骨已經重新恢復正常的放射學外觀及沒有缺血性壞死。 這證明了類固醇注射是一種安全有效的方法，以實現股骨近端巨大活躍骨囊腫的消退。 這是微創手術，沒有疤痕。 DXA掃描結合臨床評估以監測骨囊腫狀態是有效的方法以允許注射時機。 Keywords: DXA, steroid injection, Unicameral Bone Cyst