EURORAD ESR

Case 14398

Dysbaric osteonecrosis of the humerus

Author(s)
Magdalena Posadzy1, Nicolas De Vos2, 3, Filip Vanhoenacker2, 3, 4

1. W. Dega Orthopaedic and Rehabilitation University Hospital, Karol Marcinkowski University of Medical Sciences; Poznan, Poland
2. Ghent University Hospital, Department of Radiology; De Pintelaan 185, 9000 Ghent, Belgium
3. AZ Sint-Maarten Duffel-Mechelen, Department of Radiology; Leopoldstraat 2, 2800 Mechelen, Belgium
4: University Hospital Antwerp, Department of Radiology; Wilrijkstraat 10, 2650 Antwerp, Belgium; Email:filip.vanhoenacker@telenet.be
 
Patient
male, 42 year(s)
 
 
  • Figure 1
    Radiograph

    Anteroposterior (AP) radiograph of the right shoulder with the humerus in external rotation shows no abnormalities.

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: Conventional radiography; Procedure: Education; Special Focus: Trauma;
     
     
  • Figure 2
    MR arthrography, fs T1-WI

    MR arthrography, coronal fs T1-WI (A and B): irregularity in the supraspinatus (white arrow), bone marrow abnormalities in the humerus, with low SI centrally (white asterisk) and intermediate to high SI peripherally...

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: MR; Procedure: Arthrography; Special Focus: Tissue characterisation;
     
     
  • Figure 3
    Coronal T1-WI MR Images

    Coronal T1-WI (A and B): intramedullary lesion with geographical borders within the proximal diaphysis (red arrow), with epiphyseal extension (black arrow).

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: MR; Procedure: Arthrography; Special Focus: Tissue characterisation;
     
     
  • Figure 4
    MR arthrography, fs T2-WI

    MR arthrography, coronal fs T2-WI (A and B): the peripheral borders are strongly hyperintense (red arrow), while the center of the lesion remains hypointense (white asterisk).

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: MR; Procedure: Arthrography; Special Focus: Tissue characterisation;
     
     
  • Figure 5
    MR arthrography, T2-WI

    MR arthrography, coronal T2-WI: double-line sign with inner hyperintense rim (black arrow) and outer hypointense rim (red arrow).

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: MR; Procedure: Arthrography; Special Focus: Tissue characterisation;
     
     
Anteroposterior (AP) radiograph of the right shoulder with the humerus in external rotation shows no abnormalities.
 
MR arthrography, coronal fs T1-WI (A and B): irregularity in the supraspinatus (white arrow), bone marrow abnormalities in the humerus, with low SI centrally (white asterisk) and intermediate to high SI peripherally (red arrow).
 
Coronal T1-WI (A and B): intramedullary lesion with geographical borders within the proximal diaphysis (red arrow), with epiphyseal extension (black arrow).
 
MR arthrography, coronal fs T2-WI (A and B): the peripheral borders are strongly hyperintense (red arrow), while the center of the lesion remains hypointense (white asterisk).
 
MR arthrography, coronal T2-WI: double-line sign with inner hyperintense rim (black arrow) and outer hypointense rim (red arrow).
 
 
 
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