Case Challenge

Shoulder

Stephen J Pomeranz

Gain confidence interpreting Shoulder MRI Cases with MRI Online. Quiz yourself using real-world, interactive scrollable cases & earn CME!

Case Review

Musculoskeletal (MSK)

Post-Course Activities

This Power Pack is comprised of 14 unique Shoulder MRI cases that you can scroll through in our diagnostic web viewer to determine your findings. Quiz yourself and earn 7 CME.

Shoulder MRI Cases

Case 11 - 10-year-old female presents with right scapular mass and pain

<div>HISTORY:&#160;This 10-year-old female presents with right scapular mass and pain.PRIMARY FINDING:&#160;Langerhan&#8217;s cell histiocytosisUsing the&#160;diagnostic web viewer (MR) / diagnostic web viewer (CT), we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS:Focal mass lesion centered in the scapular spine, measuring 1.9 x 2 x 3.5cm in size. The lesion appears to primarily involve bone and spread along the long axis of the scapular spine, before breaching the cortex in multiple locations, particularly at the spine base. The cortex is diffusely thinned and irregular where it is not breached, with expansion of the bone. Large amount of surrounding bone, periosteal, and soft tissue edema. Focal cortical bridge/pathological fracture at the base of the scapular spine.No internal ossific matrix.No further bone lesions seen elsewhere in the scapula, the visible ribs, spine or proximal humerus.No focal mass lesion seen in the visible lungs.Although the infraspinatus and supraspinatus are mildly displaced by the mass and demonstrate muscular edema, the rotator cuff itself is intact.CONCLUSION:Focal mass lesion centered in the scapular spine and most likely a primary bone lesion that has expanded the bone and bridged the cortex, resulting in surrounding abnormal soft tissue signal. Differential includes Ewing sarcoma.</div>

Case 1

Case 2

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