About Subchondral Bone Cyst:
Subchondral Bone Cysts are referred to fluid filled sacs like structures that form in various joints of the body. The cyst usually forms in the subchondral area of the joint which is just underneath the cartilage. The function of the subchondral bone is to help absorb excessive pressure being put on the weightbearing joints of the body like the knees, hips, and shoulders. The subchondral bone contains a fluid called hyaluronic acid which is a constituent of the synovial fluid which acts as a lubricant and lowers the friction between bones when they slide against each other during movement [1].
An individual is predisposed to developing Subchondral Bone Cysts when he or she is either obese or is heavily nicotine dependent. However, the root cause for this still remains unknown. An individual with Subchondral Bone Cysts will have severe pain in the joints and using the joint for any purpose will be very difficult. Some studies suggest that Subchondral Bone Cysts are almost always followed by osteoarthritis which is a debilitating condition that affects more than 30 million people across the United States [1].
Osteoarthritis occurs when there is a gradual degeneration of the bones and cartilage of the bones causing them to rub against each other resulting in severe disabling pain with any attempts at movement. In fact, Subchondral Bone Cyst is one of the parameters that physicians look at when diagnosing osteoarthritis. However, other arthritic conditions like rheumatoid arthritis also play a key role in an individual developing Subchondral Bone Cysts. This article highlights some of the causes and treatment options for Subchondral Bone Cysts [1].
What Causes Subchondral Bone Cyst?
As stated, the primary cause of Subchondral Bone Cysts is not known. However, some researchers believe that excessive stress on the bone may be one of the possible reasons for Subchondral Bone Cysts to form. The increased stress is as a result of rapid blood flow to the subchondral bone, a phenomenon normally seen in people with osteoarthritis. There are also some risk factors which predispose an individual to developing Subchondral Bone Cysts. These factors include gender. It is seen that females are more prone to develop Subchondral Bone Cysts than males. This is based on various studies done on Subchondral Bone Cysts [1].
It has also been observed that people with a family member with osteoarthritis or a history of Subchondral Bone Cysts is also at an increased risk for developing this condition. An individual with abnormally shaped bones and joint either due to an accident or trauma or due to some genetic condition is also at an increased risk for developing Subchondral Bone Cysts [1].
People who are obese put excessive strain on the joints, especially of the lower extremities. This ultimately results in the wear and tear of the subchondral bone causing Subchondral Bone Cysts. People who abuse nicotine have increased risk for developing Subchondral Bone Cysts. This is because tobacco has chemicals which aid in destruction of cartilage and weaken the bones [1].
What Are The Symptoms Of Subchondral Bone Cyst?
An individual with a Subchondral Bone Cyst will have immense pain and discomfort at the affected joint. The joint tends to lose its flexibility as a result of the cyst in the bone. In some cases, there may also be swelling or a visible bulge around the affected joint. Aside from these, there is nothing major that is experienced by an individual affected with Subchondral Bone Cyst and the remaining symptoms are quite similar to that of osteoarthritis, especially the progressive form [1].
How Is Subchondral Bone Cyst Treated?
For managing Subchondral Bone Cysts, physicians do not remove these cysts. This is because removing them carries with it extremely high risk of infection which can prove to be detrimental for the overall health of the individual. However, in most cases these cysts fade away on their own. The treatment normally involves making lifestyle changes to control the symptoms. Joint replacement is an option in cases where the pain is unbearable and doing normal household chores becomes a challenge for the individual and the symptoms continuing to worsen [1].
In other cases, the physician will first prescribe NSAIDs in the form of ibuprofen and Tylenol to control the pain and inflammation caused by Subchondral Bone Cysts. However, this cannot be given for prolonged periods of time and thus it should be left to the discretion of the physician as to how long these medications need to be continued. The patient will also be recommended to do low impact activities like swimming and cycling to keep the joints mobile and supple [1].
Avoiding high impact activities like running and jumping will put excess pressure on the joints and worsen the symptoms. It is also essential for an individual with Subchondral Bone Cysts to maintain a healthy weight. If the individual is overweight or obese then losing weight in a healthful manner is highly recommended. This will decrease the strain that is being put on the joints of the lower extremities. Abstaining from smoking is also recommended for people with Subchondral Bone Cysts as not doing so will worsen the condition to the extent that the patient will go on to develop osteoarthritis [1].
Some studies have suggested that ultrasound therapy for treatment of Subchondral Bone Cysts has been quite effective. The ultrasound therapy is given directly to the affected area of the bone and is also quite beneficial in treating the symptoms of osteoarthritis [1].
However, more extensive research needs to be done in this sphere to determine the exact effectiveness this therapy has on people with Subchondral Bone Cysts and osteoarthritis. Physical therapy is yet another treatment option for Subchondral Bone Cysts. This is stated by none other than the American Academy of Family Physicians [1].
In conclusion, Subchondral Bone Cysts develop in the subchondral bone of various joints of the body, especially the knees, hips, and shoulders. Many studies have suggested Subchondral Bone Cysts to be precursor for osteoarthritis. In fact, other arthritic conditions like rheumatoid arthritis also have Subchondral Bone Cysts as a feature. The primary cause of Subchondral Bone Cysts is not known but there are certain risk factors which increase the risk for an individual developing these cysts [1].
These risk factors include being obese and abusing cigarettes. In majority of the cases, Subchondral Bone Cysts are not removed for fear of infection and are observed for any change in the size of characteristics. They tend to resolve spontaneously in most people. However, for the disabling pain and inflammation that they cause such that every day activities of the patient become difficult then the physician may decide on treating the symptoms [1].
This is best done making lifestyle changes and taking NSAIDs to control the pain and inflammation. Physical therapy to the affected joint is also quite helpful in making the joints supple and decrease pain and swelling. Shedding off extra weight through healthful means is also quite beneficial in controlling the symptoms of Subchondral Bone Cysts [1].
Of late ultrasound therapy has shown some promise in treatment of Subchondral Bone Cysts according to some studies but more research needs to be done to determine the true efficacy of this form of treatment for Subchondral Bone Cysts [1].
