In this feature, AAOS Now publishes a series of images, challenging readers to diagnose the condition depicted. The images published in May 2009 were of a 14-year-old male who sustained a wrist injury. They included a radiograph taken 10 days after the injury and two magnetic resonance images (MRIs). Scott Langford, MD, correctly identified the injury as a scaphoid nonunion with osteonecrosis of the proximal pole.

The images for this month’s challenge were submitted by Stephen A. Albanese, MD, and Timothy A. Damron, MD. They provide the following patient information:

“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. Two MRI views are shown.”

What’s your diagnosis? E-mail your decision and rationale to aaoscomm@aaos.org

If you have a challenging case you’d like to submit, e-mail a short case description and any accompanying images to aaoscomm@aaos.org

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