Title:Avascular Necrosis of Humeral Trochlea: A Case Report of the Rare Condition
Volume: 17
Author(s): Temel Fatih Yilmaz*, Ahmet Emin Okutan, Muhammet Salih Ayas, Mehmet Emin Dada and Ahmet Uğur Turhan
Affiliation:
- Departments of Radiology, Faculty of Medicine, Bezmialem Vakif University, Istanbul,Turkey
Keywords:
Hegemann, osteochondral defect, imaging, humerus, trochlea, avascular Necrosis, clinicians.
Abstract:
Introduction: Avascular necrosis of humeral trochlea is a very rare condition and was
described by Hegemann in 1957. We reported two cases of avascular necrosis of humeral trochlea
and also performed a literature review of the reported cases. We expect that this case report will assist
clinicians in making a timely diagnosis when encountering similar clinical scenarios.
Materials and Methods: We presented cases of an 11-year-old and a 14-year-old with avascular necrosis
of the humeral trochlea. The common etiology was idiopathic because there were no recent
trauma history and sports activity. Also, there was no history of drug use. We discussed the clinical
and radiological findings of these cases.
Results: These cases, two teenage boys, were diagnosed withHegemann’s disease with clinical and
radiological outcomes. We found that the etiology of both thecases is idiopathic;. The number of
previously reported cases in the literature is limited to 64. In our study, there was a lateral crest in
one of our two cases and a posteromedial involvement in another. The radiograph of trochleae of these
two cases showed irregularity and granular appearance. In our case, heterogeneous signal
changed and irregularities were accompanied by hypointensive changes on T1-weighted images.
Also, hyperintensive changes on proton density sequences were detected.
Conclusion: Radiological evaluation plays an important role in the diagnosis and evaluation of response
to treatment in avascular necrosis of the humeral trochlea. Avascular necrosis should be one
of the differential lesions involving the trochlea. Recognition of avascular necrosis in the trochlea
may prevent the unnecessary biopsy.
