Aneurysmal bone cysts are mainly characterized by a distinctive imaging change on X-rays where the ends of the bone are tilted to one side, called eccentric cystic lesions. Eccentric cystic changes have a shape similar to a balloon, with a cavity-like cystic change in the middle of the interior of the bone and sclerotic bands around the edges, similar to a hard shell. In some patients, the bone changes are biased to one side and have honeycomb-like imaging changes with trabecular bone formation. Often patients with aneurysmal bone cysts are prone to fracture or may bleed due to irritation. If the aneurysmal bone cyst is small, no treatment is necessary, whereas larger aneurysmal bone cysts, or cysts that are in critical areas, may undergo local debridement, including bone cement or bone tamponade. In addition, aneurysmal bone cysts of the proximal femur are more common in clinics where patients are prone to fracture of the neck of the femur, and pathologic fractures require management of the bone cyst along with immobilization.