PMC9768537_01
(A) preoperative anterior x-ray of the right femur was a multilocular cystic low-density focus with hardened edges; (B) preoperative lateral x-ray of the right femur; (C) first week of the postoperative anterior x-ray of the right femur the bone morphology of the distal right femur was satisfactory, and the internal fixation position was satisfactory; (D) first week of the postoperative lateral x-ray of the right femur the bone morphology of the distal right femur was satisfactory, and the internal fixation position was satisfactory; (E) 15 months of the postoperative anterior x-ray of the right femur showed that the fusion of the distal right femur was satisfactory, the bone quality was unchanged, the shape was satisfactory, and the internal fixation position was good; (F) 15 months of the postoperative lateral x-ray of the right femur showed that the fusion of the distal right femur was satisfactory, the bone quality was unchanged, the shape was satisfactory, and the internal fixation position was good.
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F1
X-ray revealed that the distal end of the right femur was a multilocular cystic low-density focus with hardened edges (Figures 1A,B). X-ray of the right femur was performed on the first week after the operation, the pain of VAS declined to 3 scales, and the results showed that the bone morphology of the distal right femur was satisfactory, and the internal fixation position was satisfactory (Figure 1C,D). After 15 months of follow-up, x-ray films were reviewed, and the results showed that the fusion of the distal right femur was satisfactory, the bone quality was unchanged, the shape was satisfactory, and the internal fixation position was good (Figure 1E,F).
(A) preoperative forntal CT indicating that there were multiple cystic low-density shadows in the lower part of the right femur, with clear borders; (B) preoperative horizontal cross-sectional CT indicating that there were multiple cystic low-density shadows in the lower part of the right femur, with clear borders, sclerosis margins around, and no obvious abnormalities in adjacent soft tissues.
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F2
CT revealed multiple cystic low-density shadows in the lower part of the right femur, with clear borders, sclerosis margins around, and no apparent abnormalities in adjacent soft tissues (Figures 2A,B).
(A) preoperative frontal MRI indicating multiple cystic abnormal signal shadows in the lower right femur and the surrounding soft tissues had no special changes; (B) preoperative sagittal cross-sectional MRI indicating multiple cystic abnormal signal shadows and the surrounding soft tissues had no special changes; (C) preoperative frontal contrast-enhanced MRI indicating multiple cystic abnormal signal shadows and the surrounding soft tissues had no special changes; (D) preoperative sagittal cross-sectional contrast-enhanced MRI indicating multiple cystic abnormal signal shadows and the surrounding soft tissues had no special changes.
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F3
MRI and contrast-enhanced MRI examination revealed multiple cystic abnormal signal shadows in the lower right femur, and the surrounding soft tissues had no notable changes (Figures 3A-D).
(A) after the femur was opened, the bone marrow cavity was filled with CG; (B) a part of CG removed from the right femur; (C) postoperative pathological examination film, under the microscope with 100 times, a large number of cholesterol crystals were seen in it.
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F4
A large number of yellow-brown oily crystal structures could be seen(Figures 4A,B). The pathological examination of the diseased tissue showed that new bone was seen under the microscope, cystic degeneration was seen around it, powder-stained no structure was seen in the cyst cavity, and a large number of cholesterol crystals were seen in it (Figure 4C).