Unicameral bone cyst with fracture - humerus

Case contributed by A.Prof Frank Gaillard

Presentation

Child presenting with severe pain in arm following a minor fall.

Patient Data

Age: Child
Gender: Male
X-ray

X-ray humerus

Two x-rays of the right humerus demonstrate a lucency within the proximal diaphysis with slight expansion and a fracture. Lying medially within the cyst is a fragment of cortex.

Annotated image

Fallen fragment sign

The so-called fallen fragment sign is specific for a unicameral bone cyst, with a pathological fracture. Part of the thinned cortex 'falls' into the cyst, thus indicating that the lucency is A) fluid B) uni-loculated.  

Diagram

Distribution of unicameral bone cysts

Distribution of unicameral bone cysts. Layout and distribution: Frank Gaillard 2012, Line drawing of skeleton: Patrick Lynch 2006, Creative Common NC-SA-BY

Case Discussion

Typical appearances of a large unicameral bone cyst with a pathological fracture and fallen fragment sign. 

PlayAdd to Share

Case information

rID: 12551
Published: 15th Dec 2010
Last edited: 16th Jul 2018
Tag: humerus
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.