A rare cause of shoulder pain

A 23-year-old woman presented to the emergency department with a 1-year history of atraumatic right shoulder pain. Over the preceding few months, the pain had worsened and her range of movement had reduced considerably. She was otherwise fit and healthy. On examination, her shoulder appeared normal and there was no obvious neurovascular deficit, including the axillary nerve. She had no movement in any direction actively, but passively could bring her shoulder to 60° of abduction and forward flexion. A plain radiograph of the shoulder (figure 1) shows a lobulated, expansile, ill-defined lytic lesion within the right humeral head and proximal humeral shaft. The lesion involved the diaphysis, metaphysis and epiphysis. An MRI was requested (figure 2) to help establish the diagnosis. This confirmed an expansile lesion which had replaced the humeral head and abutted the articular surface. The lesion was internally featureless, with no evidence...
Source: Postgraduate Medical Journal - Category: General Medicine Authors: Tags: Images Source Type: research