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Enchondroma of the proximal humerus

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History

Incidental finding of a left proximal humerus lesion.


Findings
Radiographs:

Lytic lesion with well defined margins, no periosteal reaction and popcorn like calcifications of the left proximal humerus (@1.1).

 

MRI:

Six centimeters lesion of the proximal humerus with lobulated contours and very high signal intensity on T2-weighted images with fat suppression (@2.9).

Focal regions of signal drop out corresponding to calcifications (@4.14) seen on x-rays.

The lesion is well-defined with normal marrow fat interposed between the cartilaginous lobules (@5.10).

After administration of gadolinium, there is a peripheral and septal ("rings and arcs") enhancement (@6.9).

No endosteal scalloping, no periosteal reaction, no soft tissue mass.

 

 

Conclusion:

Radiograph and MRI demonstrate benign cartilaginous lesion which most likely represents enchondroma of the humerus.


Diagnosis

Enchondroma of the proximal humerus


DDx
  • Low grade chondrosarcoma
  • Bone infarct

Key points

- Asymptomatic

- Well defined

- No cortical scalloping

- No soft tissue mass



Enchondroma of the proximal humerus A-P and lateral radiographs

A-P and lateral radiographs

Enchondroma of the proximal humerus Coronal T2 Fat Sat MRI

Coronal T2 Fat Sat MRI

Enchondroma of the proximal humerus Sagittal DP Fat Sat MRI

Sagittal DP Fat Sat MRI

Enchondroma of the proximal humerus Axial DP Fat Sat MRI

Axial DP Fat Sat MRI

Enchondroma of the proximal humerus Coronal T1 MRI

Coronal T1 MRI

Enchondroma of the proximal humerus Coronal T1 Fat Sat Gadolinium MRI

Coronal T1 Fat Sat Gadolinium MRI

Enchondroma of the proximal humerus Axial T1 Fat Sat Gadolinium MRI

Axial T1 Fat Sat Gadolinium MRI

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