Published 8/1/2010

What’s your Diagnosis?

In this feature, AAOS Now publishes a series of images, challenging readers to diagnose the condition depicted. These images appeared in the July 2010 issue and were submitted by Stephen A. Albanese, MD, and Timothy A. Damron, MD. The patient is a 13-year old girl with a 7-month history of right shoulder pain. The bone scan (not pictured) showed increased uptake in the right proximal humerus.

According to Michael H. McGuire, MD, the correct answer is “Chondroblastoma of the proximal humerus. The reasons include epiphyseal lesion, which is radiolucent and has a cystic component, in an adolescent complaining of pain. Plus, it looks like a chondroblastoma!”

A, Radiograph of patient’s right shoulder. B and C, Two different magnetic resonance images.

Resident members Timothy Ewald, MD, and Brandon Yuan, MD, agree. “The X-ray shows an epiphyseal lesion of the proximal humerus with a thin sclerotic rim and calcifications. The lesion also shows areas of low signal intensity centrally on T2, which is common in chondroblastoma. The location (epiphyseal, proximal humerus), age (younger than 20 years), and appearance on imaging are all indicative of chondroblastoma.”

Douglas J. McDonald, MD; Robert M. Tamurian, MD; and Neofitos Stefanides, MD, also had the correct diagnosis.

Do you have a challenging case you’d like to submit for publication? E-mail a short case description and any accompanying images to aaoscomm@aaos.org