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Case Reports
. 2024 Aug 6;19(10):4599-4603.
doi: 10.1016/j.radcr.2024.07.029. eCollection 2024 Oct.

Intraosseous pneumatocyst of the scapula: A case report

Jordan Tan Southi  1 , Thomas Estephan  1 , Amer Mitchelle  1 , Robert Loneragan  1
Affiliations
Case Reports

Intraosseous pneumatocyst of the scapula: A case report

Jordan Tan Southi et al. Radiol Case Rep. .

Abstract

Intraosseous pneumatocysts are benign, gas-filled cystic structures of bone, typically asymptomatic and discovered incidentally on imaging. Their precise aetiology remains unclear, with the prevailing hypothesis being that they result from air accumulation within the bone due to a vacuum phenomenon, typically linked to an adjacent joint space or intervertebral disc. We report the case of a 37-year-old man with an incidental intraosseous pneumatocyst of the scapula, which was evaluated with CT and MRI. Using thin-slice CT, we are able to detect a tiny cortical breach suggestive of a communication between the lesion and the adjacent glenohumeral joint, lending support to the aforementioned aetiological hypothesis.

Keywords: Benign bone lesions; Computed tomography; Intraosseous; Magnetic resonance imaging; Pneumatocyst; Scapula.

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Figures

Fig 1
Fig. 1
Left shoulder X-rays obtained in (A) anteroposterior, (B) Grashey, and (C) lateral views demonstrate the lucent lesion in the subchondral bone of the inferior glenoid.
Fig 2
Fig. 2
CT noncontrast of the left shoulder with (A) axial, (B) coronal, and (C) sagittal views demonstrates a well-defined lucent lesion within the subchondral bone at the level of the inferior glenoid. There are areas of gas density laterally (-875 HU) as well as scattered areas of fluid density medially (15 HU). An oblique view (d) was obtained via manual multiplanar reformatting, which highlights a tiny cortical breach posteroinferiorly (white arrow) suggestive of a communication between the lesion and the glenohumeral joint space. No aggressive features.
Fig 3
Fig. 3
MRI of the left shoulder with (A) proton density fat-saturated axial, (B) T2-weighted gradient echo axial, (C) proton density sagittal, and (D) T2-weighted fat-saturated sagittal sequences. Multiple gas-fluid levels are demonstrated. There is no evidence of intra-lesional fat.
Fig 4
Fig. 4
MRI of the left shoulder with (A) T1-weighted axial, (B) T1-weighted fat-saturated post gadolinium, (C) T1-weighted coronal, and (D) T1-weighted fat-saturated post gadolinium coronal sequences. No enhancing component is demonstrated within the lesion.
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