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5 year old with acute right shoulder pain after fall

Answer: Unicameral (Simple) Bone Cyst





What are the pertinent findings?

Central expanding luckent lesion in proximal humerus with thinned cortex and "fallen-fragment" sign (arrows) in pathologic fracture.


What is your differential?

Benign bone cyst
probable unicameral cyst-most common location for this

Fallen fragment sign is key finding representing a portion of the septation within the cyst which is floating within the cystic lesion.

Aneurysmal bone cyst-wrong age and location
Chondroblastoma or Osteoblastoma-not likely
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