IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Intraosseous lipoma - humerus

Case contributed by Roberto Schubert
Diagnosis almost certain

Presentation

Incidentally discovered lesion in an MRI obtained after shoulder dislocation.

Patient Data

Age: 25 years
Gender: Male

Shoulder joint

mri

An intramedullary lesion is noted at the proximal humeral epiphysis with central zone intermediate T1 signal and high signal intensity on T2 with fluid level and no suppression on PD fat sat, suggestive of unicameral bone cyst. Its peripheral zone shows high T1 and T2 signal with partial suppression on PD fat sat reflecting fat nature.

A more lateral smaller intraosseous lesion with hypointense signal on T1 and high signal on T2 with no suppression on PD fat sat, suggestive of another unicameral bone cyst.

Mild marrow edema of the humeral head, likely post-traumatic.

Moderate shoulder effusion.

Hill-Sachs and Bankart lesions are also noted.

An osteolytic lesion is noted at the proximal humeral epiphysis with sclerotic margins and peripheral fat density with central iso-density, suggestive of a fat-containing bone lesion. A smaller lateral lesion is also noted with iso-density.

Hill-Sachs and Bankart lesions are also noted.

Case Discussion

Though there is a fluid-fluid level within the central cyst on MRI, this lesion is not an aneurysmatic bone cyst, but an intraosseous lipoma with central cystic degeneration.

Also note the Hill-Sachs and Bankart lesions resulting from anterior shoulder dislocation.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

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

 Thank you for updating your details.