Unicameral bone cyst with pathological fracture

Case contributed by Dr Ian Bickle


Teenager with left upper arm pain. Clinician concerned over osteomalacia.

Patient Data

Age: 15 years
Gender: Male

Skeletally immature patient.

Lucent expansile lesion with a narrow zone of transition in the proximal metaphysis of the left humerus.  Cortical thinning of both the medial and lateral surfaces.


Films from prior admission

Fracture through the proximal metaphyseal lucent lesion.

No fragment within the lesion.

Case Discussion

A decent starter film for a fellowship exam.  A lucent bone lesion.

The examiner can use this film to:

1. assess the candidate's ability to describe a focal bone lesion

2. assess knowledge depth through inquiry into a differential

3. inquire further into additional imaging which may help (e.g. MRI to see fluid-fluid levels to distinguish between a unicameral bone cyst and aneurysmal bone cyst)

4. assess if the candidate gives a common sense/most likely diagnosis and management plan

The reality is on plain film alone it is difficult to be definitive, especially between the chief two differentials of UBC and ABC.

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Case information

rID: 60133
Published: 9th May 2018
Last edited: 14th Aug 2019
Tag: ripas2
Inclusion in quiz mode: Included
Institution: Rotherham Foundation Hospital Trust

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