Orthopaedic case discussion 1

image based Q.1. A child with shoulder swelling and pain

Question - What is the diagnosis (Given here radiograph and MRI of an eight year old child with pain and swelling right shoulder) ?





























Answer - Metadiaphyseal cystic lesion at this site, with no other history of fever or loss of weight and the presence of septa and fluid as shown in MRI as hyperintense is highly likely a simple/Unicameral bone cyst.

Question - what is 'fallen fragment sign'
Answer- some bony pieces appearing in the cavity.
 Question - Treatment modalities?
Answer - various like, aspiration, asiration with phenol or steroid injection, curretage, curreattage with bone cementation, bone marrow injection as common procedures.
Question - Is it active or latent cyst?
Answer- Active , as it appears to have a contact with physis.
Question - The common sites?
Answer - Prox. humerus(50%), prox. femur(25%)

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