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Case Reports
. 2014 Mar;19(2):354-358.
doi: 10.1007/s00776-012-0290-0. Epub 2012 Aug 31.

Rapid destruction of the humeral head due to bone fragility: report of two cases

Katsuhisa Yoshikawa  1 , Kazuya Tamai  2 , Yuichiro Yano  2 , Nakayuki Kato  2 , Miwa Akutsu  2 , Kazuo Tomizawa  2 , Yutaka Nohara  2
Affiliations
Case Reports

Rapid destruction of the humeral head due to bone fragility: report of two cases

Katsuhisa Yoshikawa et al. J Orthop Sci. 2014 Mar.
No abstract available

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Figures

Fig. 1
Fig. 1
Serial preoperative radiographs of case 1. No abnormalities were noted 3 weeks after the injury (a). However, 8 weeks after the injury, the humeral head showed a slight degree of collapse (b), which became significant 8 months after the injury (c)
Fig. 2
Fig. 2
Preoperative magnetic resonance images (MRI) of case 1. In addition to effusion, a low signal area was noted in the humeral head in proton-weighted imaging. The rotator cuff seemed intact
Fig. 3
Fig. 3
Operative findings of case 1. A deep notch was present in the center of the humeral head, which was covered with white, irregular scar tissues
Fig. 4
Fig. 4
Microscopic findings of the humeral head in case 1. Neither fat necrosis nor dead bone was noted. There were lumps of granulation tissue in the subchondral area, with some broken trabeculae and callus formation. Hematoxylin and eosin (H&E), ×100
Fig. 5
Fig. 5
Postoperative radiographs of case 1. Six years after surgery, a slight degree of arthritic change was noted in the glenoid
Fig. 6
Fig. 6
Serial preoperative radiographs of case 2. Flattening of the humeral head was noted 1 month after symptom onset (a), which became significant 2 months later (b)
Fig. 7
Fig. 7
Preoperative magnetic resonance images of case 2. T1-weighted image shows the articular surface and center of the humeral head as low signal areas. The rotator cuff is preserved
Fig. 8
Fig. 8
Operative findings of case 2. The articular cartilage was lost, and the subchondral bone was eburnated both in the glenoid (a) [a small amount of serobloody synovial fluid was seen in the glenohumeral joint (b)] and in the humeral head (c)
Fig. 9
Fig. 9
Microscopic findings of the humeral head in case 2. In some specimens, degenerated cartilage was noted (a) [hematoxylin and eosin (H&E) ×40]. There was abundant new bone formation surrounding preexisting trabeculae, which appeared near normal and did not suggest osteonecrosis (b) (H&E ×200)
Fig. 10
Fig. 10
Postoperative radiographs of case 2. Thirty months after surgery, there was no hardware failure
See this image and copyright information in PMC

References

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