case_images: PMC10787132_01
case_images: clinical image of shoulders: swelling above the left clavicle with skin redness
case_images: PAMJ-46-53-g001.jpg
case_images: PMC10787132_01_PAMJ-46-53-g001.jpg
case_images: F1
case_images: A swelling above the proximal quarter of the clavicle was noted, which was firm, painful, and fixed to the deep plane with skin redness (Figure 1).
case_images: anteroposterior shoulders X-ray: osteolytic bone lesion with cortical disruption involving proximal part of left clavicle
case_images: PAMJ-46-53-g002.jpg
case_images: PMC10787132_01_PAMJ-46-53-g002.jpg
case_images: F2
case_images: Diagnostic assessment: an osteolytic lesion on the medial part of the left clavicle with cortical disruption was noted on a shoulder X-ray (Figure 2). inflammatory markers were negative (white blood cells count was 9250 cells per mm3, creatinine reactive protein (CRP) was 8 mg/L, and the erythrocyte sedimentation rate (ESR) was 12 mm first hour).
case_images: A,B,C) clavicle magnetic resonance imaging: axial section; low intense lesion in T1-weighted images and high intense in T2-weighted, heterogeneously enhancing, edematous signal of the surrounding soft
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case_images: F3
case_images: MRI showed an extensive lesion measuring 9 x 2 x 2 cm located at the medial end of the left clavicle and extending to the acromioclavicular joint (Figure 3).
case_images: anteroposterior control shoulder X-ray: periosteal clavicle apposition with "onion bulb" shape lesion
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case_images: F4
case_images: A needle biopsy was initially performed, suspected bone infection and the child received antibiotics with no recovery and appearance of important periosteal apposition on radiographs (Figure 4).
case_images: A) hematoxylin-Eosin staining x200: Trabecular architecture of bone; B) hematoxylin-Eosin staining x400: inflammatory cell infiltration mainly including neutrophils
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case_images: PMC10787132_01_PAMJ-46-53-g005.jpg
case_images: F5
case_images: An inflammatory neutrophils and osteoclasts cells infiltration was observed (Figure 5).
case_images: bone scintigraphy: isolated isotop uptaking on the inner part of the left clavicle with no other location
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case_images: F6
case_images: Bone scintigraphy was performed and showed increased uptake on the inner part of the left clavicle with no other locations (Figure 6).