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Clinical presentation:
Male 23 years old, with a history of increasing pain in the left shoulder, relieved by aspirin.

The view shows a dense sclerosis in the proximal metaphysis of the humerus with a central lucent nidus, which is below 1cm diameter. Medially there is visible thickening by periosteal newbone, a classical appearance of this pathology. There is no indication of a soft tissue mass outside the bone.

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[Differential]

cases that might resemble this pathology

[View large image] Simple bone cyst with fracture. (case report) [View large image] Fibrous cortical defect. (case report)
[View large image] Eosinophil granuloma. (case report) [View large image] Osteomyelitis, (but low grade).
[View large image] Ewing's tumour (case report) [View large image] Osteosarcoma. (case report)
[View large image] Fibrous dysplasia (case report). Patient is a little young for Paget's disease. [View large image] Chondrosarcoma. (case report)
Sclerotic Metastasis is uncommon at this age and purely lytic proccesses, like myelomatosis or the brown tumours of Hyperparthyroidism, are also excluded by their appearance.
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[London South Bank U.]

IDM April 2007