Painful left shoulder and arm. History of metastatic breast cancer.
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Small round lucency in the mid to upper shaft of the humerus would be in keeping with a metastasis. There are a few more subtle similar lesions more distal to this. Ovoid lucency in the inferior glenoid neck region of the scapula may also represent a metastasis. Glenohumeral and elbow joint alignment appears normal. Limited views of the left chest demonstrate several pathological rib fractures in keeping with metastatic disease.
A nice example of lytic osseous metastases - and the more you look, the more you see!