动脉瘤性骨囊肿(ABCs)在足部很少见,占体内发现的所有ABCs的4%至6.3%。大约80%被诊断为ABC的患者处于生命的第二个十年。虽然良性,疼痛和畸形通常是症状。这份报告的目的是描述,根据我们的知识,首例报告的小儿舟骨ABC与小儿扁平足畸形相关,通过刮宫和植骨成功治疗。该报告的另一个目标是强调由于儿童扁平足畸形的症状重叠,这些骨性肿瘤的诊断如何容易被错过。一名11岁的女性出现在诊所,主要抱怨疼痛,步行超过2个城市街区后,扁平足畸形和内侧中足不适。该患者在外部机构接受了小儿扁平足畸形的保守治疗,并建议有必要进行扁平足手术以缓解其症状。在检查中,患者表现为舟骨内侧的局灶性疼痛。射线照片显示一个不明确的,膨胀性,舟骨硬化病变,MRI显示囊状多囊性病变,与ABC一致。治疗包括刮宫和同种异体移植包装。在1年的随访中,病人很好,具有最小的疼痛,并在没有功能限制的情况下恢复完整的活动。刮除和植骨后动脉瘤性骨囊肿的局部复发率高达22%,患者年龄和病变大小是主要危险因素。该报告证明了小儿患者舟骨内ABC的成功刮除和骨关节的保留。在1年的随访中,患者疼痛轻微,无复发迹象.
Aneurysmal bone cysts (ABCs) are rare in the foot, accounting for 4% to 6.3% of all ABCs found in the body. Approximately 80% of patients diagnosed with an ABC are in the second decade of life. While benign, pain and deformity are often the presenting symptoms. This report\'s objective is to describe, to our knowledge, the first reported
case of a pediatric
navicular ABC in association with pediatric flatfoot deformity that was successfully treated with curettage and bone grafting. An additional goal of the report is to highlight how the diagnosis of these osseous tumors can easily be missed given the overlap in symptoms with pediatric flatfoot deformity. An 11-year-old female presented to clinic with a chief complaint of painful, flatfoot deformity and discomfort to the medial midfoot after walking for more than 2 city blocks. The patient was conservatively treated for pediatric flatfoot deformity at an outside institution and advised that a surgical flatfoot reconstruction would be necessary to relieve her symptomology. On examination, the patient exhibited focal pain to the medial aspect of the
navicular. Radiographs revealed an ill-defined, expansile, sclerotic lesion of the
navicular, and MRI demonstrated a multicystic lesion filling the
navicular, consistent with an ABC. Treatment included curettage and packing with allograft. At 1-year follow-up, the patient is well, with minimal pain and return to full activity without functional limitations. Local recurrence of an aneurysmal bone cyst following curettage and bone grafting is as high as 22% with patient age and lesion size comprising the main risk factors. This report demonstrates successful curettage of an ABC within the
navicular and preservation of osseous articulations in a pediatric patient. At 1-year follow-up, the patient had minimal pain with no evidence of recurrence.