Sunburst appearance (bone)

Case contributed by Dr Maulik S Patel

Presentation

Vague history of trauma to left shoulder - about 6 wks back. Complaining of increasing swelling in left scapular region with restricted active shoulder movements. No fever.

Patient Data

Age: 15 yrs
Gender: Male
X-ray

There is periosteal reaction from scapular body - Sunburst type. There  is no fracture.

Ultrasound

There is soft tissue thickening abutting supra and infraspinus fossa of scapula. It elevates supraspinatus and infraspinatus muscle bellies. There are echogenic lines like rays from underlying scapular cortex. Cortex is is grossly irregular. There is true flow in soft tissue thickening. Teres minor muscle belly abutts scapular cortex and underlying cortex is normal.

Rotator cuff tendons are intact and normal.There is no subdeltoid - subacromial bursal effusion. There is no gleno-humeral joint effusion. There is no collection in scapular region.

Case Discussion

Adolescent male presented with scapular region swelling for last few weeks. Radiograph as well as ultrasound shows an aggressive type of periosteal reaction involving scapula - Sunburst type. It is seen with primary malignant bone tumors like osteosarcoma or Ewing's sarcoma and in osteoblastic metastastasis.

Considering patient's age, primary bone tumor is more likely the etiology.

However, there is no follow up available.

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Case information

rID: 53294
Case created: 11th May 2017
Last edited: 4th Sep 2017
Inclusion in quiz mode: Included

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