Rim rent tear and lipoma

Case contributed by Dr Andrew Lawson

Presentation

Shoulder pain and incidental X-ray finding.

Patient Data

Age: 30
Gender: Male
X-ray

There is a well-circumscribed multilobulated, densely calcified lesion along the sub-articular medial margin of the humeral head.

MRI

This is a well defined lobulated lesion with thick sclerotic rim. Internally, there is predominant fat signal with smaller peripheral areas of cystic change. No soft tissue is identified. They are no blood fluid levels.There is partial articular side tear of the entire supraspinatus, about 50% thick. No bursal fluid. There is minor subacromial spurring at the coraco-acromial ligament insertion associated with minor increased signal in the subacromial subdeltoid bursa.

Comment The lesion in the humeral epiphysis is consistent with a complicated intraosseous lipoma or less likely a old bone infarct. This is not a chondroid lesion. There is subacromial impingement associated with PASTA (rim rent tear) lesion of the supraspinatus.

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Case information

rID: 25120
Case created: 6th Oct 2013
Last edited: 1st Oct 2015
Inclusion in quiz mode: Included

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