Distal clavicular osteolysis and humeral neck stress fracture

Case contributed by Samin Khoei
Diagnosis almost certain

Presentation

Chronic shoulder pain. No history of previous trauma.

Patient Data

Age: 30 years
Gender: Male
This study is a stack
Axial PD
fat sat
This study is a stack
Coronal PD
fat sat
This study is a stack
Sagittal
PD fat sat
This study is a stack
Coronal
T1
Download
Info

Bone marrow oedema and cortical thinning are visualised at the distal clavicle. Mild widening of the acromioclavicular joint and capsular oedema are noted.

Intense bone marrow oedema is noticed at the humeral neck, associated with a transverse fracture line.

Buford complex is seen, as the absence of anterosuperior glenoid labrum and thickening of the middle glenohumeral ligament.

Mild glenohumeral effusion is visible.

Case Discussion

As a well-studied cause of adult shoulder pain, distal clavicular osteolysis (DCO) can be divided into two categories: post-traumatic and atraumatic.

Atraumatic DCO occurs as a result of repetitive stress. Main MRI findings include distal clavicular marrow oedema, cortical thinning and acromioclavicular widening.

Without a history of direct trauma, stress fractures are diagnosed on imaging with transverse or oblique fracture lines and bone marrow oedema at specific locations. They most commonly occur in the lower extremity. Proximal humeral stress fractures are less common.

This case represents two concomitant stress-induced injuries to the shoulder: atraumatic distal clavicular osteolysis and humeral neck stress fracture.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

:

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.