I am reading the current MRI and wondered if I should give a ddx for the
large dark T1 / bright T2 lesion at the end of bone in the Greater
Tuberosity, but then I saw the prior MR arthrogram from 4 years ago
[image: Cyst like changes Shoulder 44M.jpg]
This is now
[image: Cyst like changes Shoulder 44M (1).jpg]
Note the location in the Greater tuberosity, no lesion in the lesser
tuberosity
[image: Cyst like changes Shoulder 44M (2).jpg]
Now here are the images from 4 years ago….
[image: Cyst like changes Shoulder 44M (3).jpg]
There Were cystlike changes in the lesser tuberosity, the greater
tuberosity bone looked normal
[image: Cyst like changes Shoulder 44M (4).jpg]
I know I’ve seen these cyst-like changes “heal” / remodel over
time….which is why I call them cyst-like, rather than cysts—-I also
know that it can be problematic if someone were to contemplate sinking a
surgical anchor into this, so it’s worth reporting.
But I have 2 questions:
1. What are these? If not degenerative cysts, what are they?
2. I’m assuming this isn’t some other end of bone lesion (such as GCT)
because of the historic images with a similar lesion that resolved….do I
need to give a differential now, or can I simply report it as a large
subcortical cyst-like lesion.
FYI, he has supra tendinosis and small partial insertional tear, previous
history of anterior shoulder dislocation with chronic Hill Sachs.
