Weekly Case

Title : Case 676

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)


Diagnosis:

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 – 3rd edition


 



Correct Answer
Total applicants 28 Correct answers 7
Name Institution
김기욱 국군수도병원, 전문의
여현정 전문의
구보연 전공의
최형인 군의관, 전문의
김성진 365병원, 전문의
조신영 전문의
심상우 서울아산병원, 전문의
Semi-Correct Answer
Total applicants 28 Semi-Correct answers 4
이규정 국군대전병원, 전문의
김대영 전문의
전인환 전문의
김유진 전문의


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