Shoulder AP view 02

History:
66 year old male patient with known matastatic bone lesion presented with right shoulder pain

Image:


Findings:
The reporting registrar reported the film as normal. The consultant took no time to identify the subtle lucency in the humeral head, extending down the shaft and MRI was requested.

MRI:
Confirmed the plain radiograph findings.


Learning points:
1. Always have a high suspecion for metastasis in all elderly or known primary patients.
2. In exam, this film can come without clinical information. Observe the Hickman line first, which gives you a clue that the patient is on chemotherapy or IV antibiotics.