Humerus

Presenter: Dr.Raghavendar kishore (JR I)

Moderator: Dr. Pavani(JR II)
Date: 31/01/24
CONTENTS

• EMBRYOLOGY - OSSIFICATION
• RADIOLOGICAL ANATOMY
• ANATOMICAL VARIANTS
• PATHOLOGIES
– FRACTURES – CLASS ,ABC, SBC, OSTEOID OSTEOMA
m
Anatomical variants
CARRYING ANGLE
Schematic representation of
the four-segment
classification:
• Greater tuberosity (red)
• Lesser tuberosity (blue)
• Articular surface (yellow)
• Humeral diaphysis (green)
SUPRACONDYLAR FRACTURE OF HUMERUS
Arbeitsgemeinschaft für
Osteosynthesefragen /
Orthopaedic Trauma
Association
Unicameral Bone Cyst
Features of ubc
PROXIMAL HUMERUS, PROXIMAL FEMUS
• Progress towards diaphysis with skeletal
growth- reach mid diaphysis usually healed.

• Lies centrally in the shaft, expanding

symmetrically and thinning of the cortex.

• no periosteal reaction unless fracture.

• FALLEN FRAGMENT SIGN

Aneurysmal bone cyst
 UNICAMERAL BONE CYST ANEURYSMAL BONE CYST ABC

INCIDENCE BEFORE 20YRS SECOND DECADE

MALE:FEMALE 2.5:1 EQUAL
SITE PROXIMAL HUMERUS, PROXIMAL FEMUS LONG BONES, SPINE,
Other sites- calcaneus , posterior iliac blade FLAT BONE – M/C PELVIS
Presentation mostly as fracture Secondary to primary bone lesions,-
gct, fibrous dysplasia ,
osteoblastoma, chondroblastoma

MRI findings Lesion heterogenous intermediate

Fluid content of lesion demonstrate SI inT1W, and thin sclerotic margin
homogenous low to intermediate SI with internal hypointense internal
on T1W and marked hyperdensity septations, which enhance in gd
on T2W contast.
T2W/PDW multiple air fluid level

DD ABC, Fibrous dysplasia Telangiectasia osteosarcoma

 SIMPLE BONE CYST
SBC
Radiological • Progress towards diaphysis with •
features skeletal growth- reach mid
diaphysis usually healed.
• Lies centrally in the shaft,
expanding symmetrically and
thinning of the cortex.
• Apparent Trabeculation is
common , no periosteal
reaction unless fracture.
FALLEN FRAGMENT SIGN
Fragment of cortex penetrating the
cyst linning.
ANEURYSMAL BONE CYST
ABC
A thin EGG SHELL covering of
the expanded cortex.
• Purely lytic, Expansile intra
medullary lesion in the
metaphysis of long bone
extending to the growth plate.
• Apparent Trabeculation due to
ridging of the endosteal cortex.
• BUBBLY APPEARANCE
Ct shows fine septal ossifications
Osteoid osteoma
SUMMARY
• OSSIFICATION OF HUMERUS - PH -6 1 5 – CRITOE (1 3 5 7 9 11)
• ANTERIOR HUMERAL LINE AND RADIOCAPITELLAR LINE
• ANTERIOR AND POSTERIOR PAD OF FAT significance
• SURGICAL NECK # - AXILLARY NERVE, CIRCUMFLEX A (AXILLARY A)
• SHAFT OF HUMERUS# – RADIAL N , PROFUNDA BRACHI A
• DISTAL HUMERUS # - MED-EPI – ULNAR N, LAT – EPI – RADIAL N
• NEER CLASSIFICATION – 4 PARTS – PROXIMAL HUMERUS
• GARLAND CLASSIFICATION – SUPRACONDYLAR #
• AO/OTA FOR PROXIMAL AND DISTAL HUMERUS
• SBC VS ABC
References
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(2014). Grainger & Allison’s diagnostic radiology E-book (6th ed.). Churchill Livingstone.
• Keats, T. E., & Anderson, M. W. (2012). Atlas of normal roentgen variants that may
simulate disease: Expert consult - enhanced online features and print (9th ed.). Saunders.
• Hasan, U. (2019). “The Humerus Side of Radiology”: A radiographic review of various
lesions within the humerus. European Congress of Radiology.
https://doi.org/10.26044/ECR2019/C-0380
• Veeramani, R., Holla, S. J., Parkash, C., & Chumber, S. (Eds.). (2017). Grays anatomy for
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THANK
• Radiology masterclass. (n.d.). Radiologymasterclass.co.uk.

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