Anatomical Variant of Upper Humerus Notch in a Pediatric Case

Wahab A Gbadamosi1, Lena Naffaa2

  • 1Diagnostic Radiology, Medical Center of Trinity, Trinity, USA.

Cureus
|June 12, 2023
PubMed

Insights

A benign upper humeral notch variant in children can mimic a lytic bone lesion, causing parental anxiety and unnecessary tests. Radiologists should confirm bilaterality with contralateral views to prevent misdiagnosis.

Area of Science:

  • Pediatric Radiology
  • Skeletal Imaging
  • Medical Diagnostics

Background:

  • Bony lesions in children often cause significant parental anxiety and can lead to extensive, costly diagnostic workups.
  • Misinterpretation of normal bone variations can result in unnecessary biopsies and advanced imaging.

Observation:

  • A five-month-old infant presented with a cough, and a chest X-ray incidentally revealed a lytic lesion in the right humerus.
  • Extensive diagnostic imaging was performed, which ultimately identified the lesion as a normal bone variation.

Findings:

  • The identified lesion was a benign upper humeral notch variant, a normal anatomical finding.
  • This variant can be mistaken for a pathological lytic bone lesion on initial imaging.

Implications:

  • Familiarizing radiologists and clinicians with this benign variant can prevent misdiagnosis.
  • Obtaining contralateral view radiographs is crucial for confirming bilaterality and avoiding unnecessary advanced imaging, costs, and parental anxiety.

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