Abstract
IntroductionOsteoarthritic subchondral cysts within or around the hip joint can sometimes be difficult to distinguish from primary osseous and soft tissue tumors due to their radiological appearance and uncommon location.Case presentationWe report the case of a 74-year-old Turkish man with a subchondral cyst arising from the hip joint, eroding the acetabulum and located on the medial side of the iliac bone, which imitated a soft tissue tumor. This cystic lesion was resected and the results of histopathological analysis of tissue samples were found to be consistent with an osteoarthritic cyst.ConclusionsThe present case illustrates how an osteoarthritic subchondral cyst can grow into the soft tissue planes in the presence of destruction of the articular cartilage and subchondral bone continuity, and present as an apparent soft tissue tumor.
Highlights
Osteoarthritic subchondral cysts within or around the hip joint can sometimes be difficult to distinguish from primary osseous and soft tissue tumors due to their radiological appearance and uncommon location.Case presentation: We report the case of a 74-year-old Turkish man with a subchondral cyst arising from the hip joint, eroding the acetabulum and located on the medial side of the iliac bone, which imitated a soft tissue tumor
Osteoarthritic subchondral cysts frequently occur in weightbearing joints such as the hip
The etiology of these cysts in hip OA remains uncertain. Theories on their pathogenesis include that they originate from intrusion of synovial fluid into the bone at the joint surface, initiate in areas of bone necrosis, or are confined to pressure segments in the femoral head and acetabulum [3,4,5,6,7,8]. Regardless of their etiology, subchondral cysts are generally thought to develop in bone adjacent to highly degenerated joint surfaces and, as a result, are frequently found in weight-bearing areas of the osteoarthritic hip joint at the time of total hip arthroplasty [8]
Summary
Osteoarthritis (OA) is a degenerative joint disease with some radiological characteristics including the presence of multiple, small cysts (geodes) with subchondral sclerosis, marginal osteophytes, intra-articular osteochondral bodies and narrowing or loss of joint space [1,2]. Theories on their pathogenesis include that they originate from intrusion of synovial fluid into the bone at the joint surface, initiate in areas of bone necrosis, or are confined to pressure segments in the femoral head and acetabulum [3,4,5,6,7,8] Regardless of their etiology, subchondral cysts are generally thought to develop in bone adjacent to highly degenerated joint surfaces and, as a result, are frequently found in weight-bearing areas of the osteoarthritic hip joint at the time of total hip arthroplasty [8]. Coronal T2-weighted fat-saturated (A) and T1-weighted fat-saturated contrast-enhanced (B) magnetic resonance imaging scans showing a cystic lesion located on the medial side of the right iliac bone. Primary total hip replacement surgery for both hips was recommended in view of the radiological findings
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