Presentation
Minor trauma to the right arm.
Patient Data
Age: 12 years
Gender: Female
From the case:
Pathological fracture - pediatric
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Spiral pathological fracture of the proximal right humeral shaft through a well-defined expansile geographic lytic lesion with a fallen fragment sign. Homogeneous matrix with no enhancement following IV contrast. Small periosseous hematoma with no soft tissue component or periosteal reaction.
Case Discussion
CT features of a pathological fracture with an underlying lytic lesion most consistent with a unicameral bone cyst (also called a simple bone cyst).
The fallen fragment sign is considered to be pathognomonic for a simple (unicameral) bone cyst following a pathological fracture. It refers to the presence of a bone fracture fragment resting dependently in a cystic bone lesion.
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