Aneurysmal Bone Cysts

 (Updated 3/9/2021
An aneurysmal bone cyst (ABC) is a painful condition in which an aggressive, cystic (fluid filled cavity) lesion develops in a bone, usually following a fracture or trauma, sufficient to alter the venous circulation of the bone.  It can also develop from pre-existing bone tumors.   It is typically found between the ages of 10-30, with the peak age of 16.  The most common site is the knee region (proximal tibia), followed by the arm bones, spine, and upper leg (femur).  ABCs have also been documented in small tubular bones of the foot, and skull.

The symptoms of an aneurysmal bone cyst depend on the affected area.   A common presentation is relatively fast onset of pain that rapidly increases in severity over 6-12 weeks.

The  skin surface temperature over the cyst may increase, a hard, bony swelling may be felt , and movement in an adjacent joint may be restricted.

Spinal lesions may cause radiating nerve pain or quadriplegia, and patients with skull lesions may have moderate to severe headaches.

Although aneurysmal bone cysts are relatively rare, I decided to address this disorder because the symptoms may be wrongly interpreted as a sprain or strain, especially for ABCs that affect the posterior elements of the spine.   A wrong diagnosis will lead to the wrong treatment prescription, such as ongoing chiropractic adjustments or physical therapy, which can worsen the condition.

If you have a teenager who complains of sudden, focal pain around a bone, frequently the knee, it’s best to take your child to his/her primary care physician, who should order a skeletal X-ray.  X-rays are the preferred imaging study to diagnose ABCs.

aneurysmal bone cyst knee xray

There are several treatment options for aneurysmal  bone cysts.  Surgical curettage, which is basically scraping out the cyst; embolization of the cyst (blocking its feeding veins and arteries), and injection of drugs to inactivate the cyst.

Aneurysmal bone cysts are not serious conditions at the same level of osteosarcoma, but they should be dealt with as soon as possible to prevent worsening.  They reduce the strength of bones and often lead to bone collapse/ fracture that could be dangerous.

There are surgical interventions that involve reducing the cyst.  You may want to try pulsed electromagnetic field therapy (PEMF) over the lesion.  PEMF is the external application of electromagnetic field energy into the body.  The field is low frequency and low amplitude and is similar to the natural magnetic fields produced by your body.  It is known to enhance cell membrane transport and improve red blood cell flow within the small capillaries.  For more information on Pulsed EMF, click Here.

How to Tell if Your Pain is from Arthritis

Arthrite rhumatoide Source: http://nihseniorhe...

Image via Wikipedia

If you have deep, achy pain in a joint that doesn’t go away with time it’s likely some form of arthritis.  Lower back pain can be arthritic in nature (as opposed to muscle) if it behaves similarly– deep, achy, doesn’t seem to ever go away entirely; and you have a history of repetitive, physical impact to your body such as construction workers/ laborers, martial art practitioners and gymnasts.  However, with rheumatoid arthritis (explained below) no history of trauma is necessary.

Most people associate arthritis with the elderly.  But did you know it can affect younger people as well?

The word arthritis translates to “joint inflammation.”  There are several forms of arthritis, the two most common types being rheumatoid arthritis and osteoarthritis.

Diagram of a synovial (diarthrosis) joint.

Image via Wikipedia

Rheumatoid arthritis (RA) is an auto-immune disorder, where the body’s white blood cells attack the synovium of synovial joints.  Synovium is the inner lining of a synovial joint— encased (capsular) joints like in the spine, hips, knees and shoulders.  The synovium produces synovial fluid, which lubricates the inner surfaces of the joint as it moves.

People suffering from rheumatoid arthritis will have  bouts of severe joint swelling, redness, heat and pain.  RA is typically bilateral; meaning, for the extremities it strikes both sides, not just one.  It is an awful condition that can can severely impact mobility.  Those with rheumatoid arthritis in the knuckles of the hand will have difficulty gripping things and doing fine dexterity movements such as writing and buttoning a shirt.  Areas commonly affected by rheumatoid arthritis are the hands, spine, and feet.

Currently, drugs are the only medical treatment for RA including non-steroidal anti-inflammatories– NSAIDS (aspirin, Motrin, Tylenol, Ibuprofen), corticosteroids and immunosuppressives.

Palliative care to manage pain levels include acupuncture, yoga, and chiropractic.  Cannabis (medical marijuana) is a popular choice for many sufferers.

Osteoarthritis (OA) is described as joint pain and inflammation from wear and tear of the cartilage.  It is usually found in people who have suffered repeated joint trauma, like football and basketball players.  Marathon runners can develop it in the knees and hips as well.  OA is found in the weight bearing joints of the feet, ankle, knees, hips, lower spine and neck.

When repeated trauma impacts a weight bearing joint, over time it creates tiny fissures in the cartilage, which thins the cartilage and exposes the bone underneath.  From there, the bone forms bone spurs called osteophytes.  Radiologists describe these changes (disc degeneration plus osteophytes) as spondylosis of the joint.

Both types of joints can be painful, with RA being more acutely painful.  The symptoms are pain, joint stiffness and reduced range of motion.

MAKING BONE BROTH SOUP FOR ARTHRITIS PAIN:

In both cases, eating a low-inflammation diet will be helpful:  reduce sugar intake including high fructose corn syrup; limit carbohydrates to 150 grams per day; emphasize protein and fat, especially fish with high Omega 3 content; nut oils (walnut, almond, Brazil nuts), virgin olive oil, and raw plants (green leafy salads, lightly steamed vegetables).   Raw milk and butter from grass fed cows, and coconut oil are also good for an anti-inflammatory diet.

Eating  bone broth soup every day will give your body the constituents for rebuilding cartilage:  Visit your local butcher and ask for the large beef and pork joints.  They can saw these in little pieces in the back and give them to you in a bag; they price them pretty cheap; too!

You’d be amazed as to how cow/ pig knee and hip joints look very much like a human’s.  If you want to understand the anatomy of these joints, this is a great way to do it.  You will see and feel the smoothness of the cartilage on the femur head.  You’ll see the anterior and posterior cruciate ligaments (ACLs and PCLs).  You will see the patella, fat pad; and collateral ligaments, condyles and meniscus.  Make sure to eat all of these parts in addition to drinking the broth to get all the proteins needed to rebuild tendons, ligaments and cartilage.

MAKING THE BROTH:

Add a couple of pieces of joints into a tall pot; fill half-way with water; add salt.  For extra bone-building strength add some eggshells (from cracked RAW eggs– You want the inner shell membrane to be intact; with boiled eggs the nutrient-rich membrane sticks to the egg).  Bring to a strong boil; reduce heat to low and cook for 60 minutes.  Steep out the eggshells, and drink the soup.  Eat any pieces of tendon stuck to the bones, and eat the bone marrow as well.  You can add spinach to the soup the last minute of boiling for more variety. (chicken and turkey carcasses and whole fish bones work well, too).

The calcium and cartilage nutrients you get from this bone broth can help your joints feel better.

HOME THERAPY FOR ARTHRITIS

Arthritis pain comes from inflammation and stimulation of pain receptors in damaged cartilage by the inflammation and also by physical abrasion.

Pulsed electromagnetic field therapy (Pulsed EMF or PEMF) can help by energizing the affected cells.  The electromagnetic field produced by PEMF machines are similar to the naturally-occurring fields produced by the biological activity of your cells; adding an external source helps those cells function better.  The few cells that exist in the cartilage and ligaments and tendons have more energy to synthesize matrix and collagen which goes towards joint rebuilding.  Use in conjunction with red light therapy for maximum effect.  Red light at around 660 nm wavelength initiates photobiomodulation, which also gives cells more energy to function, much like photosynthesis in plants.

For temporary relief, heat works best with chronic pain and stiffness.  An infrared heat lamp is a good choice, as it is easy to set up and penetrates all the way down to the affected tissue, unlike a hot pack which only heats the skin.  Heating is not advised for rheumatoid arthritis when it is in a flare-up, hot and acute phase.

As far as medical care, joint replacement is a more drastic option but can effectively reduce pain while preserving some joint functionality.  There are also experimental procedures that involve culturing cartilage cells in a lab and injecting them into the joint space, hoping that they will bond to existing cartilage and thicken, but results are mixed at this point.

If you don’t have arthritis, do things that will help prevent you for getting it.  Build up your joint strength with the diet mentioned above, and avoid repetitious trauma to the weight bearing joints (activities that involve jumping and landing on a hard surface).  Strengthen surrounding ligaments of your knee and hip joints with exercises like weightless squats, knee bends, and simple uphill hiking.

Your joints are the most neglected part of your body; we often take them for granted.  But when one is injured or develops arthritis, you will realize very quickly how important they are to your happiness and well-being.  Don’t wait until it is too late; strengthening and nurturing your joints should be a definite part of your fitness routine.

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