Workup Of Progressive Shoulder Pain Leading To The Diagnosis Of A Lytic Bone Lesion - Page #3
 

Lab Studies:
No significant laboratory findings.

Other Studies:
X-rays of left shoulder revealed narrowing of space between the acromion and humeral head. MRI was obtained and revealed small left glenohumeral joint effusion, degenerative changes at acromioclavicular joint, and abnormal marrow signal in bones of left shoulder. Nuclear medicine bone scan revealed only degenerative changes.

Consultations:
Biopsy performed by Orthopedic Oncology described area as a large void in the bone and hypercellular bone marrow with megakaryocytic clustering. Pathologist was unable to provide definitive diagnosis. Bone marrow biopsy consisted predominantly of blood clot and small fragment of bone with crushed marrow, but the amount of hematopoietic elements present were insufficient for evaluation.

Patient later presented to ER for persistent and worsening left shoulder pain. CT of neck and chest revealed a left lung mass with mediastinal lymphadenopathy as well as a left supraclavicular soft tissue mass and adjacent adenopathy.

Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.


NOTE: For more information, please contact the AMSSM, 11639 Earnshaw, Overland Park, KS 66210, (913) 327-1415.
 

© The American Medical Society for Sports Medicine
4000 W. 114th Street, Suite 100
Leawood, KS 66211
Phone: 913.327.1415


Website created by the computer geek