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Shoulder bone cysts and fractures

Quick background: I am a 33 year old female. Never had issues with bone density or breaks.

Last year (16 months ago) I fell with an outstretched arm and suffered a proximal humeral fracture in my right shoulder. I am about 90% healed with some pain when I raise my arm.

4 months ago, I picked up my 7 year old daughter and heard a pop in my left shoulder, followed by pain. After several visits to and orthopedic doctor, I've been diagnosed with a slight labral tear and a bone cyst in my left shoulder. The doctor talked about digging out the cyst, followed by packing the space with a bone graft and a plate.

After doing some research my questions are: Isn't this something that occurs in young children, especially boys - not a 33 year old woman? Is it likely that my first fracture (right shoulder) could have been caused by a bone cyst? Are there any other options other than surgery? and if I do get the surgery, is the bone cyst likely to reoccur?

I know that's quite a few questions, and I'd be grateful for any light shed on my case. Thank you.
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replied April 22nd, 2013
Especially eHealthy
mcmammajama,

If you are speaking of unicameral bone cysts (also called simple bone cysts), then yes, those are most commonly seen in children.

But, the term "cyst" is often used generically for any lytic lesion seen in bone. It does not give you a diagnosis as to what it actually is in the bone.

Since you have had a fracture in the area, it could be from healing of the fracture. Fractures are first "glued" back together with osteoid, which is the soft tissue matrix of bone. Then, the body calcifies the osteoid, to make callus (new bone formation). Occasionally, the body does not completely calcify the osteoid, leaving a area that is not fully filled in with bone. This can cause a weak spot in the bone.

It could be that you have one of the many different types of bone "tumors", which cause a lytic lesion (eg giant cell tumor). But, until the material within the "cyst" is removed and sent to pathology for examination, a firm diagnosis cannot be made (though many lesion do have very characteristic appearance on x-ray).

If the lesion is making the bone weaker, or you want to know what is causing the lesion, then have the surgery. But, it is a pretty good sized operation. If you decide to have the surgery, be sure to have some help around the house, because as you know from your fracture, you are going to be laid up for a while.

Good luck.
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