Background and purposeRecent data suggest that percutaneous sclerotherapy is a safe alternative to surgery for treatment of aneurysmal bone cysts (ABCs). We present our experience of this method.MethodsWe retrospectively analyzed data from 38 consecutive patients treated with repeated injections of polidocanol. Each injection consisted of 2–4 mg polidocanol per kg body weight. Radiological and clinical assessments were performed until healing.ResultsAll cycts except 1 healed after a median of 4 (1–11) injections. A lesion failed to heal in 1 patient, who was operated. 3 patients experienced minor local inflammatory reactions.InterpretationOur results show that percutaneus sclerotherapy with polidocanol has high efficacy in the treatment of ABCs, with a low frequency of side effects. Our findings corroborate data presented in previous publications. We believe that the method will be especially valuable in ABCs of the pelvis and sacrum, where surgery is associated with considerable morbidity.
Imaging-guided core biopsy is a reliable method for obtaining a tissue diagnosis in pathologic fracture of the appendicular skeleton with a high rate of accuracy. However, those lesions that are purely intraosseous or have only very small extraosseous components are more likely to be associated with a nondiagnostic biopsy and should be considered for a primary open procedure.
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