Presentation
Fall in play park. Left shoulder pain and reduced range of movement.
Patient Data
Sclerotic metaphyseal lesion with wide zone of transition, periosteal reaction and pathological fracture. Features of an aggressive lesion.
Case Discussion
A young boy presented with a painful left shoulder after a fall.
Left metaphyseal aggressive bone lesion. The differential is wide and includes osteosarcoma and Ewings. LCH should probably also sit in the differential. This does not look like infection.
A fall onto the shoulder has resulted in a pathological fracture.
Staging MR of the humerus confirmed it as a solitary lesion. Referral to the bone tumor service was made. Biopsy confirmed osteosarcoma. Chest CT confirmed multiple lung metastases.