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. 2022 Aug 9;52(9):1601–1614. doi: 10.1007/s00247-022-05396-6

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© The Author(s) 2022

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Fig. 2 — Rapid progression of a proximal humeral aneurysmal bone cyst from a type I to a type II in a 5-year-old girl. a An initial anteroposterior radiograph of the shoulder shows a proximal metadiaphyseal, lytic lesion (asterisk) of the humerus. The lesion causes endosteal scalloping (arrows), is slightly expansile and has no internal septations or matrix. b An anteroposterior radiograph of the shoulder obtained 7 months later shows significant interval growth of the lesion (asterisk) with blurring of the physeal margin. The lesion is now expansile and has marked cortical thinning (white arrows) with no sclerotic border or areas of mineralization. Aggressive periosteal reaction (black arrows) is identified at the distal margin of the lesion. c An axial fat-suppressed T2-weighted magnetic resonance (MR) image of the humeral lesion shows the expansile, multiseptated humeral lesion with a dominant cystic cavity (asterisk), fluid-fluid levels (black arrows) and mild adjacent soft-tissue edema (white arrows). d A coronal fat-suppressed, contrast-enhanced T1-weighted MR image of the humeral lesion clearly shows the focal bone expansion and physeal involvement (black arrow). The lesion is multicystic; the dominant cyst (white asterisk) displays peripheral contrast enhancement and areas of enhancing solid tissue (black asterisks). A rim of peripheral enhancing edema is present (white arrows)