PMC3504258_01
Plain radiographs of the upper extremity taken 8 years earlier revealed a destructive lytic process involving the humerus, radius, and ulna with pathologic midshaft humerus fracture and chronic dislocation of the humeroulnar joint.
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fig1
X-rays taken at that time revealed a destructive lytic process involving the humerus, radius, and ulna with chronic dislocation of the humeroulnar joint (Figure 1).
Anteroposterior and lateral plain radiographs of the humerus with diffuse osteopenia and extensive radiolucent foci in the intramedullary and subcortical regions of the bone, and disappearance of the midshaft humerus with tapering of the bone ends. Multiple lytic lesions of the scapula are also visible.
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She had multiple lytic lesions of the scapula and disappearance of a section of the midshaft of the humerus with tapering of the ends of the bony remnants (Figure 2).
Anteroposterior and lateral plain radiographs of the elbow showing dislocation of the humeroulnar joint and fragmentation and disappearance of the distal humerus.
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Her distal humerus was partially fragmented and dissolved with dislocation of the ulnohumeral joint (Figure 3).
Anteroposterior and lateral plain radiographs of the forearm with multiple subcortical radiolucent foci of both the radius and ulna and subluxation of the distal radioulnar joint.
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Both the radius and ulna were involved with multiple radiolucent foci and subluxation of the distal radioulnar joint (Figure 4).
Photomicrograph from the proximal humerus biopsy shows (a) an area of trabecular bone that has been replaced with new vascular channels (hemangiomatous) as well as (b) fibrous tissue replacing the absorbed bone without evidence of regeneration of the bone matrix (hematoxylin & eosin stain, original magnification x100).
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An open bone biopsy of the midshaft of the humerus was performed (Figure 5).