A bone cyst is a benign, tumor-like change on the bone that is filled with fluid. Often, bone cysts do not cause any symptoms and are therefore discovered only by chance in the context of another disease. Treatment is not necessary in every case, but depends on the individual case.
What is a bone cyst?
A bone cyst is a benign, non-tumorous change on the bone. They consist of fluid-filled cavities in the bone that can vary in size. Bone cysts frequently affect children up to the age of 15, although boys are more often affected than girls. In many cases, bone cysts do not cause any symptoms and are therefore only discovered by chance during examinations. In other cases, the bone cysts grow together completely unnoticed at the end of growth, have never caused any symptoms and are therefore not noticed. Even if a bone cyst is discovered, however, treatment is not always necessary. If there is no risk of secondary diseases, it is possible to simply wait for the cyst to grow. Bone cysts are divided into juvenile bone cysts (single-crested) and aneurysmal bone cysts (multi-crested).
Causes
The exact causes of bone cyst formation are unknown. However, it is thought that injury to the bone or blood clots can trigger bone cysts. Inflammation or developmental disorders are also considered possible causes. Bone cysts mainly affect children up to about the age of 15, but more rarely they occur in young adulthood. Bone cysts occur most frequently in children up to 10 years of age. Bone cysts in children mostly occur in the upper arm bone or the thigh bone. Since they very often do not cause any symptoms, they are often discovered only by chance. Such as when a bone fracture is present and therefore an X-ray examination becomes necessary. In some cases, bone cysts can also be responsible for a fracture because they reduce the stability of the bone.
Symptoms, complaints, and signs
Bone cysts usually do not cause noticeable symptoms. However, a cyst in the bone increases the risk of fractures. For example, the growth affects the stability of the affected bone, and blood flow to the surrounding area may also be reduced or completely cut off by the cyst. If blood no longer reaches the surrounding tissue, serious complications can develop, including necrosis. In individual cases, bone cysts can cause pain. The affected person then suffers from an indefinable, pulling pain that occurs primarily with stimuli such as cold or heat. Large cysts can cause persistent pain and thus impair well-being. Rarely, visible swelling or redness forms in the skin area. However, these are usually not associated with pain and quickly subside. Bone cysts in the area of the head, spine, genital area and knee can cause various functional disorders. Bone cysts usually form quite suddenly and are discovered much later. They grow rapidly, but are relatively harmless due to their benign form. They usually join with the surrounding tissue as soon as the growth phase is completed. The bone cysts are then no longer visible even on an X-ray.
Diagnosis and progression
Bone cysts usually do not cause any discomfort to the affected person, so a doctor is rarely consulted specifically because of them. If a bone fracture occurs, a bone cyst may be responsible for it and is often discovered when an existing bone fracture is diagnosed more precisely by means of X-ray examination. A bone cyst can be seen as a bright spot on the X-ray image. If a bone cyst is discovered, the decisive factor is whether this cyst poses a danger to the bone. This is always the case if the bone is limited in its stability by the bone cyst and therefore a bone fracture is imminent. Treatment should also be given if the bone cyst is responsible for a present bone fracture. In all other cases, therapy is not necessary because most bone cysts disappear on their own as they grow. By the end of the growth phase at the latest, bone cysts are then no longer recognizable.
Complications
A bone cyst does not necessarily lead to complications or limitations in every case. It is usually benign and therefore does not always need to be treated. In this case, the affected person may suffer from developmental disorders or even movement disorders and restrictions in everyday life as a result of the bone cyst. In most cases, however, there is no pain. The patients also suffer more from bone fractures, so that they occur more easily and more readily. The stability of the bones and thus of the entire body decreases. As a result, the affected person is usually also less able to bear weight. If the cyst is not dangerous for the bone, it is usually not removed or treated further. In most cases, cysts are only discovered by chance during check-ups. However, if the cyst causes discomfort, it can be treated with cortisone. This does not lead to complications. Furthermore, surgical treatment is also possible. The life expectancy of the patient is not reduced by this disease. Only in rare cases there are restrictions in the patient’s daily life.
When should one go to the doctor?
If there are repeated bone fractures and pain or swelling around the bones, a bone cyst may be present. Medical advice is required if the symptoms significantly affect the well-being, do not subside on their own or become more severe within a short time. Chronic complaints must always be clarified by a specialist and treated if necessary. Otherwise, serious complications may develop. If further symptoms occur, it is best to consult a doctor on the same day. In the case of recurring complaints for which no cause can be found, a specialist should be consulted. Children complaining of pain in or around the bone should be taken to a pediatrician. However, the first port of call otherwise should be the family doctor or an orthopedist in any case. Close consultation with the medical professional is necessary during treatment. If side effects and interactions occur after taking the prescribed drugs, this must be clarified, as well as recurring pain and other symptoms.
Treatment and therapy
Treatment of a bone cyst depends on its extent and its potential effects on the body. In many cases, no treatment is necessary because secondary damage from the bone cyst can be largely ruled out. If there is an increased risk of bone fracture due to the bone cyst, appropriate therapies should be initiated to remove the cyst and thus prevent a bone fracture. Juvenile bone cysts can be treated very well with cortisone. In this case, the cortisone is injected directly into the cyst and causes the bone cyst to gradually disappear. In some cases, it may be necessary to clear out the bone cyst with surgery and fill the cavity with bone material. This measure is the treatment method that promises the most success. In addition, so-called decompression screws can also be inserted into the bone. These ensure that the bone cyst heals. In the case of an aneurysmal bone cyst, however, therapy is more often required to prevent permanent damage to the bone. Since an aneurysmal bone cyst, in contrast to the juvenile bone cyst, is very well supplied with blood, there is very strong growth in this type. In this process, the bone substance is increasingly used up and thus the bone is damaged and unstable. Therefore, aneurysmal bone cysts can also cause pain. In these cases, treatment of the bone cyst is recommended. In most cases, this is a surgical procedure in which the cyst is drained and filled with bone material or even cement. However, aneurysmal bone cyst is a very rare condition.
Outlook and prognosis
The prognosis for a bone cyst is usually favorable. It is a benign change that is usually diagnosed only by an incidental finding in children and adolescents. The cyst rarely causes physical symptoms. Therefore, some affected persons may have bone cysts in their organism for a long time and still not notice any impairment in their daily activities. A shortening of the lifespan or other secondary diseases are also not given with this disorder.Often, no treatment is needed or performed due to the low need for action. In a large number of patients, the diagnosis is made on the basis of a bone fracture. Under certain circumstances, this may have been triggered by a cyst. With early and professional medical care, the fracture heals completely without further complications within a few weeks or months. If not already done independently, the existing cyst is removed in parallel during treatment. Residues or further inconveniences usually do not occur. Despite the favorable prognosis, the cyst may re-form in the further course of the child’s development. In these cases, the prospects for healing as well as the course of the disease remain positive. If the bone cyst is noticed, it can be removed if desired.
Prevention
Because the causes of bone cysts are not clearly understood, there can be no direct recommendation for prevention. Also, the causes suspected of triggering a bone cyst are difficult or impossible to influence.
Follow-up
Removal of the bone cyst is often uncomplicated, so extensive aftercare is not necessary in many cases. Nevertheless, there are some points to consider after surgery. Immediately after surgery, it is important to watch for signs of a rare infection in the operated area. The typical symptoms such as redness, hyperthermia, swelling and throbbing pain are reason to visit the doctor. This is even more true in the case of fever. The earlier an infection is detected, the better it can usually be treated. The second point of aftercare concerns the functionality of the affected bone. Wearing a cast and sparing the affected area should really only be done for as long as the attending physician recommends. He can assess when the bone is again sufficiently resilient for the demands of everyday life, work and leisure. Resting for too long during aftercare can also be counterproductive if it is at the expense of strength and mobility. If the resilience is to be increased gradually, this can be accompanied by a physiotherapist. Sports during the aftercare period should be discussed with the physician. In particular, strong compression due to jumps should be avoided, as well as the risk of injuring oneself in duels.
This is what you can do yourself
In the case of a bone cyst, there are usually no special self-help options available to the affected person. However, further treatment of such a cyst depends on its position and extent, and treatment or removal is not necessary in every case. In most cases, bone cysts are treated with the help of cortisone, resulting in a positive course of the disease. However, affected individuals should avoid bone fractures and thus dangerous sports or activities in general. If the bone cyst causes pain, painkillers can also be taken. These should only not be taken introduced over a longer period of time, as they can otherwise damage the stomach. The doctor may also be able to give the patient a local analgesic injection to relieve the discomfort. If the bone cyst causes psychological discomfort, discussions with other patients or with close friends and family are suitable. Exchanging information with other patients can often make everyday life more pleasant. Other people’s feelings of success can also relieve psychological discomfort and accelerate the healing of the disease.
