Imaging features of subperiosteal aneurysmal bone cyst.
OBJECTIVE
To analyze the imaging features of subperiosteal aneurysmal bone cyst.


METHODS
The imaging material of 6 patients with biopsy-proved subperiosteal aneurysmal bone cyst was reviewed. Evaluation included patient demographics, lesion location and size, radiographic features, and intrinsic characteristics on CT and MR images. Review of histologic specimens was carried out by an experienced musculoskeletal pathologist.


RESULTS
All lesions were located at the surface of long tubular bones (femur 3, tibia 2, humerus 1): 3 involved the diaphysis, 2 the dia/metaphysis, and 1 exclusively the metaphysis. Lesion size ranged from 2.5 to 6 cm in maximum diameter. Radiographs and CT images always showed a superficial bone defect, which on radiographs demonstrated irregular margins in 4 cases. All lesions caused an interrupted periosteal reaction (shell 3, trabeculated shell 1, Codman angle 2). MR images always showed a multicystic appearance with a hypointense rim, contrast-enhancing cyst walls, and fluid levels. Edema of adjacent soft tissues was present in all cases.


CONCLUSIONS
Aneurysmal bone cyst in a subperiosteal location can demonstrate an aggressive radiographic appearance. MR imaging appears to be most valuable in the differential diagnosis, since it can demonstrate typical morphological features of the underlying process.
Woertler
K
K
Department of Radiology, Technische Universität, Munich, Germany.
Brinkschmidt
C
C
D000293:Adolescent; D000328:Adult; D017824:Bone Cysts, Aneurysmal / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D005269:Femur; D006801:Humans; D006811:Humerus; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010521:Periosteum; D013977:Tibia; D014057:Tomography, X-Ray Computed