Weekly Case

Title : Case 652

Age / Sex : 15 / M

Chief complaint : Right elbow pain

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 : 
Chee Choong Guen, Asan medical Center



periosteal osteosarcoma



Radiographic findings

 - Aggressive, interrupted pattern of periosteal reaction at posterior aspect of humerus


  1. Sono findings:

- juxtacortical hypoechoic mass with peripheral peritumoral increased vascularities

- hyperechoic shell like multiple foci, which is suggestive of aggressive periosteal reaction

    2. MRI findings

Juxtacortical soft tissue mass with T2 hyperintensity at posterolat. aspect of the dist. humeral metadiaphysis, Rt.

  - size: 0.9 x 1.6 x 1.7cm

- contrast enhancement mainly along peripheral portion of the mass

  - several dirputed area of presumed elevated periosteum.

- reactive enhancement in the medulla of the distal humerus

- adjacent soft tissue signal change with enhancement, invovling triceps, ECRL, brachialis muscles, probably reactive


Differential Diagnosis:

  • Subperiosteal Abscess

  • Juxtacortical chondrom


RadioGraphics 2010; 30:1653–1672

Correct Answer
Total applicants 22 Correct answers 10
Name Institution
송옥규 전문의
홍상협 군의관, 전문의
김지은 서울대학교병원, 전문의
장성원 중앙보훈병원, 전공의
김동언 국군양주병원, 전문의
최형인 군의관, 전문의
김형민 전문의
장민영 국민건강보험공단 일산병원, 전문의
권기언 명지병원, 전공의
김성진 365병원, 전문의
Semi-Correct Answer
Total applicants 22 Semi-Correct answers 1
백승진 분당차병원, 전공의