![Painful left shoulder. [Musculoskeletal] [XR] [MR]](https://lemmy.world/pictrs/image/02bb52e0-f432-49b9-ab06-52803b446f32.jpeg){kind=link}
Female in her 30s with painful left shoulder.
[Left]: X-ray shows a mass arising from the left proximal humerus and extending into the adjacent shoulder soft tissues with really aggressive periosteal reaction (“hair on end”). The proximal humerus itself is also heterogeneous with lucent areas. The lateral surface of the upper humerus shows “saucerization,” where the cortex is thinned out and looks like a saucer seen on edge.
[Middle]: MRI IR sequence shows a hyperintense bony mass with large soft tissue component.
[Right]: MRI postcontrast T1 IDEAL shows that the mass is enhancing.
This turned out to be high-grade surface osteosarcoma.
Ah interesting, thank you! What are those tendrils - is it possible to say? I would imagine they’re not blood vessels, as that would make me assume you’d also be able to see the rest of the normal, healthy vasculature in the body.
Not sure, I’m also a layman when it comes to X-ray interpretation. Given the MRI showed it was a bony mass, I’m going to guess the tendrils are themselves bone tissue.
It’s called periosteal reaction. Here’s a few examples I posted already: one, two.