Humeral and glenoid osteolytic lesions

Case contributed by Dr Bahman Rasuli

Presentation

Left shoulder pain and swelling.

Patient Data

Age: 55 years
Gender: Male

Ill-defined lytic lesions over the left glenoid and proximal humerus with the focal loss of the cortex at the humerus head and irregularity of the glenoid inferior cortex.

Abnormal signal ( low on T1/intermediate on T2/PD fs ) soft tissue lytic destructive osseous lesions involving the glenoid and proximal humerus causing the cortical destruction of the humerus and glenoid posterior cortex and a soft tissue component which expands mildly out of the posterior side of the lesions

Abnormal intrasubstance increased fluid signal and thickening along with supraspinatus, infraspinatus, and subscapularis tendons related to tendinosis

Moderate joint effusion

Subcoracoid and subacromial/subdeltoid bursa

Tenosynovitis of the long head of biceps tendon

Capsular hypertrophy and degenerative changes along with the AC joint

Acromion type II

Degenerative changes as cartilage thinning and fraying associated wth subchondral cystic changes at the glenoid bone.

Case Discussion

The glenoid and humerus lesions imaging appearances are in keeping with a malignant bone lesion.

Metastasis, chondrosarcoma, osteosarcoma and lymphoma could be considered in the differential diagnosis. 

This patient had no known background of malignancy and refused biopsy or follow up management of the osteolytic lesions.

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Case information

rID: 82980
Published: 12th Nov 2020
Last edited: 15th Nov 2020
Inclusion in quiz mode: Included
Institution: Jame Jam Imaging Center

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