ke/sb/rg.
/585 Date : 00.00.0000

Name of the Patient : Abc Xyzr Salulmn / M / 40 yrs.
Referred by : Dr. Abc XyzV. Shah.
Examination : M.R.I. of the Right Shoulder.

CLINICAL PROFILE :

H/O fall of a heavy object on the right shoulder with pain in the right shoulder joint and inability to lift the RUE since then.

EXAMINATION :

M.R.I of the right shoulder was performed using the following parameters :

7 mm thick T1 Weighted and T2 Weighted axial images.

7 mm thick T1 Weighted sagittal images.

5 mm thick T1 Weighted and T2 Weighted coronal images.

OBSERVATION :

There is replacement of the normal marrow of the head and the upper third shaft of the right humerus by hypointense areas on the T1 Weighted images which turns heterogeneously hyperintense on the T2 Weighted images. There is a clear zone of transition between the lesion and normal marrow. There is a suggestion of break in the medial cortex of the proximal right humerus with subtle hyperintense signal in the adjacent soft tissues in the infraspinatus muscle. Subtle altered signal is also noted deep to the subscapularis muscle and posterior to the humeral head. Minimal fluid is noted in the right shoulder joint.

The glenoid labrum is unremarkable. The biceps tendon in the biciptical groove shows normal signal intensity.

The articular cartilage of the head of the right humerus appears normal.


The tendinous insertion of the supraspinatus muscle shows normal signal intensity. There is no evidence of fluid in the subdeltoid bursa. There is no evidence of a tear of the supraspinatus muscle.

The acromio-clavicular joint is normal.

The visualized axilla is unremarkable.

IMPRESSION :

Altered signal in the head and the upper third shaft of the right humerus with soft tissue extension as described is not specific for a single etiology. This most likely is a neoplastic lesion. Round cell tumors/metastasis should be ruled out.

The possibility of post-traumatic etiology is less likely.