Pseudocyst of the humerus also referred as a humeral head pseudolesion, is a normal anatomical variant due to increased cancellous bone in the region of the greater tubercle of the humerus which is seen as a lucent lesion on radiography.
Hyperemia and disuse caused by shoulder problems (such as rotator cuff disorders) cause this area of lucency to appear more lucent and mimic a lytic lesion (e.g. chondroblastoma, infection, or even a metastatic focus) and mistakenly undergo biopsy.
Therefore, pseudocyst of the humerus is one of the skeletal "do not touch" lesions.
Radiographic features
Plain radiograph
May show a lucent lesion in the region of the humeral greater tubercle, often with a somewhat well defined inferior curvilinear margin whilst the upper margin is generally ill-defined 2. Pseudocysts are thought to be so radiographically characteristic that they should not be biopsied.
CT
Similar appearances to those on plain radiograph.
Nuclear medicine
Bone scan
Bone scan may show increased radionuclide uptake due to hyperemia (and thus convince the surgeon to perform a biopsy).
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