PMC5721314_01
Radiograph of right shoulder shows dense, linear calcification in the distal metaphysis "white line of Frankel" (curved arrow) and periosteal separation (red arrow).
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F1
X rays of the right shoulder showed: osteopenia, an irregular thickened white line at the upper humeral metaphysis, a zone of rarefaction under the same metaphysis and a periosteal reaction (Fig. 1).
The sagittal ultrasound image shows heterogeneous hypoechoic lesions compatible with subperiosteal abscess (red arrow).
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F2
Humerus (Fig. 2). Hence the diagnosis of subperiosteal abscess fistulized in soft tissues was suggested.
Shouldar MRI.
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F3
Needle insertion into the fluid collection yielding a gelatinous red material in the operating room.
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F4
A surgery was quickly considered and the aspiration of the collection by a needle bringing back a gelatinous red liquid (Fig. 4).
Subperiosteal hematomas evacuated after surgical approach.
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F5
After surgical approach, it was clear that the collection interpreted as abscess was just a subperiosteal hematoma without any sign of infection (Fig. 5).