|Case of the Week - Patient Summary 6088|
Peer Reviewed and Certified -
|Demographics: 42 y.o. man|
|History & Chief complaint:|
| 42 year old WM with no significant prior medical history or recent trauma, presents with 2 month history of left glenohumeral and subscapular pain. Suspicious of rotator cuff pathology, MRI left shoulder requested. |
|Physical exam and Laboratory:|
| No significant range of motion limitations or weakness. |
|Summary of Findings:|
|Routine radiographic examination of the left shoulder reveals a lucent lesion in the proximal humeral metaphysis extending over 5.2 cm superior to inferior. The margins of the lesion demontrate sclerosis. The lesion does not cross the physis.
MRI examination of the left shoulder following the
administration of intravenous contrast.
No rotator cuff or labral pathology noted. Degenerative changes of acromioclavicular joint are noted.
There is marrow replacement demonstrated in the humeral metaphysis over a 4.1-cm superior to inferior extent, that does not cross the physeal plate. There is shallow endosteal scalloping and increased signal on fat-suppressed T1-weighted images consistent with proteinaceous material. Minimal expansion is seen
anteriorly at the level of the bicipital groove. There is a thin rim of low signal surrounding this lesion, consistent with sclerosis. There is no evidence of pathologic fracture.
|Simple (unicameral) bone cyst
Aneurysmal bone cyst
| Simple (Solitary or Unicameral) Bone Cyst |
|Treatment and Followup:|
|Shoulder pain attributed to degenerative changes in acromioclavicular joint. No specific treatment required for unicameral bone cyst, unless determined to be expanding. Follow-up radiographs periodically to asses for change.|
|Patient Specific Discussion: (Also Read the Disease Discussion)|
|Imaging characteristics are typical for a unicameral bone cyst. The age of presentation is somewhat atypical as these lesions commonly present in children, often with pathologic fracture.|