Sakroiliak bölge yerleşimli iliak kemik kistleri: Sakroiliak ağrının nadir görülen bir nedeni

Öz

Amaç: Bu çalışmada nadir görülen bir sakroiliak eklem kaynaklı ağrı nedeni olarak iliak kemiğin sakroiliak eklem komşuluğunu tutan kistik kemik lezyonlarını tanımlamayı amaçladık.

Çalışma planı: Enneking ve Dunham’a göre Zon 1 yerleşiminde selim kistik kemik lezyonu bulunan ve iki yıllık takibi olan 9 hasta çalışmaya dahil edildi. İleri radyolojik inceleme manyetik rezonans görüntüleme veya bilgisayarlı tomografi ile yapıldı. Tüm hastalara genişletilmiş küretaj, fenol ve termal koterizasyon ile adjuvan tedavi ve otogreft/allogreft kemik ile greftleme uygulandı. Hastalar lezyon başlangıcındaki yaş, lezyonun bulunduğu taraf, klinik ve radyolojik bulgular, tümör evresi, komplikasyonlar ve son kontrollerindeki klinik ve radyolojik bulgular açısından incelendi.

Bulgular: Kadın hastaların erkek hastalara oranı 4/5 idi. Tanı anında ortalama yaş 40.3 (dağılım: 27-54) iken, ortalama lezyon çapı 6.6 (dağılım: 4-11) cm olarak saptandı. Bir olguda yüzeysel enfeksiyon, iki olguda insizyon çevresinde hipoestezi meydana geldi. Tüm hastalarda ağrı ve aksama şikayetlerinde düzelme rapor edildi. Ortalama 30.7 (dağılım: 21-40) aylık takip sonrası radyolojik olarak nüks gözlenmedi.

Çıkarımlar: Sakroiliak eklem kaynaklı ağrının ayırıcı tanısında selim tümör benzeri kistik kemik lezyonları göz önünde bulundurulmalıdır. Bu tür lezyonlar genişletilmiş intralezyonel küretaj, lokal adjuvan tedaviler ve greftleme ile güvenli ve etkin bir şekilde tedavi edilebilmektedir.

Anahtar Kelimeler

• Anevrizmal kemik kisti; basit kemik kisti; pelvis; sakroiliak ağrı.

Iliac bone cysts adjacent to the sacroiliac joint:an unusual cause of sacroiliac pain

Abstract

Objective: The aim of this study was to describe cystic bone lesions involving the sacroiliac region of the iliac bone as a rare cause of sacroiliac joint-related pain.

Methods: The study included 9 patients with benign cystic bone lesion in Zone 1 according to Enneking and Dunham with a minimum of 2 years follow-up. Detailed radiological examination was performed using magnetic resonance imaging or computed tomography. Extended curettage, adjuvant treatment with phenol and thermal cauterization and bone grafting with auto/allografts were performed. Patients were analyzed for age of onset, side of involvement, clinical and radiological findings, tumor stage, complications and clinical/radiological findings at the final follow-up.

Results: Female to male ratio was 4 to 5. Average age at the time of diagnosis was 40.3 (range: 27 to 54) years. Average diameter of the lesion was 6.6 (range: 4 to 11) cm. Superficial infection was detected in one patient and hypoesthesia around the site of incision in two. Clinical improvement in pain and limp was reported in all patients. No radiological recurrence was detected after an average follow-up time of 30.7 (range: 21 to 40) months.

Conclusion: Benign tumor-like cystic lesions should be kept in mind in the differential diagnosis of sacroiliac joint-related pain. Such lesions can be safely and effectively managed with intralesional curettage, local adjuvant methods and bone grafting.

Keywords

• Aneurysmal bone cyst
• pelvis
• sacroiliac pain
• simple bone cyst

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