Disease is one of the most unpleasant things that can happen in our lives or the lives of our loved ones. And sooner or later, everyone is faced with some kind of ailment that affects certain organs or systems of the body. That is why it is so important to pay attention to yourself and undergo examinations from time to time in order to be sure that you are he althy or to diagnose diseases in time.
Human Skeleton
Our entire body supports the skeleton, which is made up of 207 bones. People suffering from bone diseases know first hand how painful the consequences of these ailments can be, and they do not always appear in the first stages. Whatever the disease, it must be treated so that it does not progress and does not give complications. Bone cyst refers to tumor diseases, fluid is localized in the bone cavity. In this place, blood circulation is disturbed, and pathogenic substances destroy the tissue structure.
Varieties of the disease. Aneurysmal cyst
Cysts are divided into two types, and each of them has its own specifics. There is a solitaryand aneurysmal bone cyst. The latter are more common in adolescent girls aged 10 to 15 years. Most often, the bones of the pelvis and spine suffer from the lesion, pathology can occur after an injury. The affected area is swollen and painful, when examined, the doctor can see dilated saphenous veins, this place is hot to the touch compared to other parts of the body.
If the disease affects the lower limbs, then the support is broken, and the patient's gait may also change. Very often, contracture of the joint develops, which is closest to the formation. When the disease affects the bones of the vertebra, neurological disorders occur, this is due to the fact that the spinal roots are compressed.
Forms and phases of the course of the disease
There are two forms of aneurysmal bone cyst: eccentric and central. There are also phases, each of which has its own manifestations. In the phase of osteolysis, the disease is at its peak, during this period, on x-rays, you can see a focus that does not have a structure. The focus has an intraosseous and extraosseous component. The periosteum is preserved. Further, delimitation occurs, and the zone inside the bone is separated from the he althy bone, and a site is formed between them - sclerosis. The extraosseous area becomes denser and smaller in size.
Gradual fading comes in the phase of reduction, and in the recovery phase we can say that the person is he althy, but the images can still see the residual cavity - hyperostosis.
Tumor-like bone lesion
Bone damage can be different, but it is the aneurysmal bone cyst that belongs to tumor-like, albeit benign, formations. Its etiology is not clear and consists of numerous spaces that are filled with blood. Most often they are diagnosed in adolescents and children. Patients under 20 years of age are at risk for this disease, it is 80% of patients in this age category.
The clinical picture is not always pronounced, and the disease can be diagnosed only when the patient goes to the hospital with a fracture. During examinations, all laboratory tests are within normal limits.
Tumor sites
Bone cyst is a pathology and consists of vascular spaces filled with blood. These spaces of different sizes can be filled with a fluid similar to blood serum, they are separated by connective tissue septa. An accurate diagnosis is established with the help of an x-ray. In this case, it makes no sense to conduct a biopsy, because this procedure is of no diagnostic value and receives only fresh blood in the aspirate.
In the vast majority of cases, ACC is a primary lesion and is not the result of a concomitant disease, but in rare cases it may be accompanied by any pathological processes. Cysts can occur in the tubular bones of the lower and upper extremities.
Children and adolescents most often suffer from the disease due to the fact that the focus is localized precisely in unclosed growth zoneslong tubular bones, namely in the metaphyses.
Tubular bones are affected in 60% of all cases, of which 40% are the bones of the lower extremities. Bone cyst of the tibia and fibula occurs in approximately 24%. The femur is affected in 13% of cases.
The upper limbs are affected a little less frequently, in percentage terms they account for 20%, the spine and sacrum - up to 30% with a frequent transition to the body of the spine and its rear elements.
Similar cysts are also found in the bones of the skull. Wherever the formation appears, it can and should be treated, and the sooner it can be diagnosed, the better.
Carrying out diagnostic manipulations
The most effective diagnostic methods for this disease are computed tomography and radiography. The bone cyst is a well-demarcated lesion with sclerotic margins. On CT, all changes are clearly visible, violation of the cortical layer and how much the lesion has spread into the soft tissues. Fluid levels can be detected on CT, but MRI is somewhat more difficult to detect, but such diagnostics are also carried out.
In aneurysmal bone cysts, fluid is a characteristic feature, but you should not be guided by this alone, because the presence of fluid in the bone tissue can be a signal in other benign as well as malignant lesions. Fluid collects in bone in osteosarcoma, giant cell tumor, chondroblastoma, and simple bone cyst.
Cause of disease development
To prevent any disease or its recurrence, it is important to know the cause of its occurrence. In this case, the pathology develops due to the fact that not enough blood is supplied to the organ due to some circumstances. For this reason, this area does not receive the full amount of minerals and vitamins that are necessary for normal functioning. Oxygen is not supplied in the required volume, and tissue destruction occurs. A cyst forms in this place.
There are a number of reasons that contribute to the development of the disease, but they are not one hundred percent guarantee that it will develop.
Chronic bone defects, bone dystrophy and trauma - all this can cause the patient to have additional he alth problems. But, besides this, anomalies of intrauterine development are also possible, which do not go anywhere with the birth of a child. If the mother led an unhe althy lifestyle during pregnancy, then the child can receive a bone cyst "as a gift" from the mother.
Bone cyst and mechanism of its development
It all starts with the fact that blood circulation is disturbed in a limited area of \u200b\u200bthe bone. The supply of oxygen and nutrition are disturbed, and this area begins to break down, lysosomal enzymes are activated, which break down collagen, glycosaminoglycans and other proteins. A cavity filled with liquid is formed, in which there is a high osmotic and hydrostatic pressure. Due to this pressure and a large number of enzymes in the liquid, destruction beginsbone that is around a bone cyst. The period of the disease can last up to two years, with a favorable outcome during this period, the fluid pressure should decrease and the activity of enzymes should decrease. The active phase of the disease is replaced by a passive one, and over time, the cyst disappears, and new bone tissue replaces the affected areas.
The recovery period occurs in the second year of the course of the disease, x-rays are taken at the end of treatment to make sure that the person is he althy.
How is treatment carried out?
After the cyst is diagnosed, it is recommended to unload the limb with the affected bone. If a fracture occurs in this place, then a cast is applied for a period of 6 weeks.
Treatment of a bone cyst is carried out by conservative methods. With the help of needles for intraosseous anesthesia, the contents of the cavity are removed. To reduce the pressure inside the cyst, numerous perforations of the walls are performed. Further, the cleavage products and enzymes are removed from the cavity, washing is done with distilled water or saline. To neutralize fibrinolysis, the cavity is washed with a solution of aminocaproic acid. At the end of the procedure, aprotinin is administered. For adults over 12 years of age and large cysts, hydrocortisone and triamcinolone may be given.
The frequency of the procedure in the treatment of an active cyst is about once a month, if the cyst closes, then the frequency can be about 1 time in a month and a half. For the entire period of treatment, 6 to 10 punctures are performed.
The entire treatment path is accompanied by X-ray control. When the first signs are observeddecrease in education, the patient is sent to exercise therapy.
If conservative treatment does not give the desired result, or the formation is in an uncomfortable place and there is a threat of compression of the spinal cord or the risk that bone destruction will be significant, then this is an indication for removal of the bone cyst through surgical intervention.
Marginal resection of the affected area with alloplasty of the defect is performed. It is very risky to carry out operations in the active phase, they are done only in extreme cases. There is a chance to catch the growth zone and damage it, and this can lead to the fact that the limb will lag behind in growth in the long term. In addition, when the cyst and the growth zone come into contact on the bone, relapses are possible.
Thus, the main directions in conservative treatment are immobilization, punctures and the introduction of drugs into the cyst cavity. Physiotherapy and exercise therapy are prescribed. When there is no effect from conservative treatment, then resection and subsequent alloplasty is done.
How dangerous is this disease?
It is very important to go from the onset of the disease to a full recovery, and in the future not to have any problems in this area. If a child was diagnosed with a bone cyst of the humerus, then I want to know how this will affect later life. With such diagnoses, one can count on a favorable outcome and a good prognosis. After reduction of the cavity, the patient recovers and is not limited in any way in his ability to work.
Consequences may be long-termtime and are related to the fact that contractures were formed as a result of the disease, massive destruction of the bone tissue was found, in which the deformation of the limb occurred. But if the recommendations of the doctors were followed and adequate timely treatment was carried out, then such an outcome is very rare.
Solitary cyst
It is worth saying a little more about this type of cyst. Boys suffer from it more often, adults rarely hear such a diagnosis, usually these are residual effects after an undiagnosed illness suffered in childhood. The bone cyst of the femur and shoulder take the first place here. In the early stages, there are no symptoms. The patient may report minor pain and swelling. Depending on the location of the lesion, lameness may appear.
Sometimes the diagnosis is made only at the time of admission to the hospital with a fracture. In this place, the tissue becomes thinner and even with a minor injury, a fracture occurs. Locally, during examination, these places are not expressed in any way, there is no edema or hyperemia. There is no venous pattern on the skin. Only on palpation can you feel a thickening with bone density. If the cyst is large, then its wall may sag when pressed. When there is no fracture, then the movements and support are completely preserved. Here, the same stages of the course of the disease are observed as in the case of an aneurysmal cyst. Strength at the site of the hollow bone is reduced, pathological fractures can occur here.
In the last stages there is a complete recovery, there may be a small cavity or a limited areaosteosclerosis.
Symptoms associated with this condition
Not necessarily all of the symptoms described below indicate that the patient has a cyst, but if one has formed, the patient may have such manifestations.
In the first stages, there are no signs at all. Much later, swelling and seals appear in the affected areas. Pain during this period does not attract much attention and does not cause discomfort. There is a formation of the contour of the secondary joint. The bone cyst of the tibia, reaching a large size, can give lameness and discomfort when moving. Often the first symptom to diagnose the disease is a fracture.
If a cyst has formed in the femur, the patient may feel pain in the hip joint, as a result, you can dislocate the leg, break the femoral neck and limp on the leg. If the problem is in the bones of the spine, a teenager may experience dizziness, headaches, and tinnitus. The work of the bladder and intestines is disturbed. There is paresis of the upper and lower extremities. Heel mass with no symptoms.
After the diagnosis is established, conservative treatment or bone cyst surgery is performed. It is impossible to leave the disease unattended, because additional complications arise.
Possible complications without treatment
In the rarest cases, a cyst does not need to be treated. The disease goes away on its own, and only years later can an adult accidentally identify whenexamination that he had a cavity in the bone. But if the disease is diagnosed, then you should not hope that everything will pass by itself. Negligent attitude to he alth can lead to bone destruction, degeneration into a malignant tumor and limb deformity.
After full recovery, relapses are possible, in order to avoid this, you need to eat right, be extremely careful and avoid injuries, lead a he althy lifestyle and, of course, undergo preventive examinations from time to time. In 95% of cases, the outcome of this disease is favorable, which is good news.
Tooth cyst
Education can appear not only in tubular bones. A cyst in the bone tissue of the tooth is also diagnosed. Inflammation and maturation of the granule occurs. This is the body's defense response to injury or infection.
The formation looks like a bubble that can reach several centimeters in diameter. It is filled with pus or fluid.
A cyst appears due to the development of an infection in the canal of the tooth. The cause may be an injury or chronic disease of the nasopharynx and oral cavity.
Periodontitis or periodontitis can provoke the disease. If the child has reduced immunity or caries, a cyst may also develop. There are many more prerequisites for a tooth cyst than for the development of other types of cysts. Even poor-quality installation of a crown or filling can provoke such a development of the disease. The difficult stage of wisdom teeth eruption also causes this disease.
Cyst symptomstooth
Like all other types of cysts, at the first stages it is very difficult to diagnose. Tooth discoloration and discomfort when chewing hard foods are overlooked by many. Pain can only occur when the granule is about 1 centimeter in size. Here the signs become very bright and pronounced, it may seem that the problem arose instantly and out of the blue.
In the area of inflammation, pain is felt, swelling passes to the face. Lymph nodes increase in size and become painful. If the cyst is located in the maxillary sinuses, then a headache appears and the temperature rises.
To save the child from these problems, it is necessary to perform an operation and remove the cyst along with the tooth. It is imperative to consult a doctor, only he can determine whether it is a granuloma or a cyst. There is a significant difference between them, because the granuloma is often enough to be treated therapeutically, and the cyst requires the use of drastic measures.
The cyst can be on the root of the tooth, and on the gum, found in the maxillary sinus or under the crown of the tooth. Often, parents bring their child to the dentist for a check-up with complaints of toothache, but after the picture is taken, the cause of the pain becomes clear. The dentist does not deal with this issue, he gives a referral to the surgeon, who is already performing the operation to remove the tumor.
