Presentation
Right shoulder mass for several years without any pain.
Patient Data
On plain film, there are multiple well-defined broad-based exostoses at metadiaphyseal region of the proximal humerus, continuous with the parent cortex and trabeculae. The lesions are directed away from the shoulder joint.
On MRI, the lesion arises from the lateral, medial and posterior aspect of the proximal humerus and shows cortical and medullary continuity with parent bone. A thin layer (6 mm thick) of hyaline cartilage cap of T1 low signal and T2 high signal is seen.
Case Discussion
MRI is the best imaging modality to demonstrate cortical and medullary continuity between the osteochondromas and parent bone. On MRI, thin hyaline cartilage cap of low to intermediate signal on T1 sequence and high signal on T2 sequence reflects its high water content. When there are multiple osteochondromas, the condition is termed hereditary multiple exostoses or diaphyseal aclasis.
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