This case shows an unusual location of the aneurysmal bone cyst in the sacrum, when assessed by MRI study, it demonstrates the typical imaging appearance of expansile multiseptated lesion with multiple fluid-fluid levels.

Part of the imaging work up is to do an angiogram study to assess for feeding vessels to plan for embolization. Other options of treatment include corticosteroid or alcohol injections. This patient received no interventions and was followed up by serial imaging over a period of 4 years and show significant regression of the bone cyst.