Presentation
History witheld.
Patient Data
Expansion of the proximal humeral shaft with sclerotic and cystic change.
Typical appearances of a simple or unicameral bone cyst in the upper humerus with pathological fracture and resultant "fallen fragment".
Patient was treated expectantly (non-surgical management the cyst) resulting in the appearances of the previous film, where the cyst has almost healed by sclerosis apart from a small residual cystic component in the upper lateral aspect. Note the site of fracture is still seen as a transverse linear lucency with sclerotic margins in the mid medial aspect of the lesion.
Case Discussion
This case illustrates the importance of reviewing previous imaging. In the absence of the original image from 2009, the most likely cause for this appearance would be fibrous dysplasia so it is always very important to try and review any previous images when making a definitive diagnosis of bone lesions especially in the developing skeleton.
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