Age / Sex : 63 / F

Chief complaint :

Clavicle fracture after slip down.  Persistent pain during conservative therapy.


What is your diagnosis?

Two weeks later, you can see the final diagonosis with a brief discussion of this case (Please submit only one answer).


Courtesy : 김태은(Kim Tae Eun), 대구파티마병원(Daegu Fatima hospital)

Post-Traumatic Osteolysis

Discussion

Findings:

 Irregular erosion of fracture site of the clavicle is noted in 2month-f/u plain radiograph.

 MRI shows erosion with adjacent bone marrow edema at fracture site.

Differential Diagnosis:

 Malignant, infectious, and  inflammatory process

Discussion:

 Some degree of bone loss is common after a traumatic insult, particularly when complicated by a fracture, in certain situations and sites, however, the degree of post-traumatic osteolysis may be excessive. Knowledge of the existence and appearance of such osteolysis is important so that the resorption of bone that accompanies a traumatic insult is not mistaken for an inflammatory or neoplastic process.

 The osteolytic process may begin as early as 2 to 3 weeks and as late as several years after the injury.

Common sites of post-traumatic osteolysis

; Distal portion of clavicle, pubic and ischial rami, distal portion of ulna, distal portion of radius, carpus, femoral neck.

References:

1. Bone and joint imaging – 3^rd edition