![]() Multiple small lyitc areas witje surrounding sclerosis. Usually a metaphyseo-epiphseal lyic lesion in skeetally mature Langerhans cells with eosinophillic cytoplasmĪ lytic expansile lesion with trabeculationĬavernous blood filled spaces without endothelial lining with numerous giant cells and spindle cells Usually a lytic area along with tophi at other usual sitesīony resorption, lytic areas along with brown tumor in other usual sitesĪsymptomatic/features of hyperparathyroidismĪ lyitic expansile lesion usually at metaphyseo-epiphyseal region Mostly bilateral lytic lesion, with other characteristic features of rickets in other metaphyseal region Lytic lesion with surrounding sclerosis, may show sequestration Non progressive/slowly progreesive swellingĬaseous necrosis with giant cell granuloma Lytic lesion with bony destruction with osteoporosis The management was on the basis of the diagnosis of the lesion.Īverage pre treatment/post treatment UCLA* Visual analogue scale (VAS) was used for pain assessment. We were not able to use scores in 1 patient with age 3 years and he was evaluated on pain and active shoulder movements which improved after anti-tubercular therapy. There were marked improvement in the scores with all patients achieving near normal functions and pre illness work status. 11 The scale incorporated pain, movement, function and patient satisfaction. The objective assessment of function in pre and post treatment was done using University of California, Los Angeles (UCLA) shoulder rating scale. The material was sent for histopathology, pus culture and sensitivity, gram stain, acid fast stain and culture on Lowenstein-Jensen medium. MRI (Magnetic resonance imaging) were ordered in all symptomatic lytic lesions of clavicle followed by a tru-cut biopsy when diagnosis was not clear. Serum uric acid was also investigated in adult patients. All patients were subjected to routine investigations including complete blood count including ESR(erythrocyte sedimentation rate), baseline liver and renal function and Mantoux test, serum calcium, phosphorous and ALP (alkaline phosphate), CRP(C- reactive protein) and X-rays of bilateral clavicle. An informed consent was taken for their enrolment in study. Patients with less than 24 months of follow up were also excluded.Ī thorough clinical examination was done in all patients presenting either with pain or swelling in or around clavicle. All lesions that were benign and lytic with or without sclerotic component were included. The patients with malignant lesions including multiple myeloma, traumatic lesions and metastasis were excluded from the study. Patients with all age group presenting with a lytic lesion in clavicle were included in the study. The aim of this study was to establish etiological basis for benign lytic lesions presenting to our tertiary centre and identify clinical, radiological and pathological characteristics of these etiologies.Ī prospective study of benign lytic lesions of clavicle was performed from 2008 to 2013. Prompted by the rarity of lesion and scarcity of data regarding presentation and management, we performed a prospective study on benign lytic lesions of clavicle. Asymptomatic nature of lesions, their rare occurrence, the difficulty to read the X-rays because of surrounding structures and striking similarities in various lesions further make the diagnosis of such atraumatic lytic lesions difficult. ![]() The data on benign lytic lesion is however sparse. The benign lesions are infrequent and most common is osteochondroma, which radiologically is bony outgrowth - pedunculated or sessile. 4-10 Even this data mostly revolves around the malignant lesions which are by far more common than benign lesions. 3 With the exception of traumatic lesions and tuberculosis of clavicle, most data on clavicle in literature is regarding its neoplastic lesions. 1, 2 It is only ironic that a bone with so many unusual features is one of the least studied bones. ![]() It is the only long bone to lie in horizontal position, no well defined medullary canal and has a membranous ossification. It is the first bone to ossify and has 2 primary and one secondary centre of ossification. Clavicle is a bone with numerous peculiarities.
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