Not Your Everyday Knee Pain

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Not Your Everyday Knee Pain - Page #3

Lab Studies: Xray of the R Knee - Normal Case Photo #1 Xray of the R Hip - AP pelvis and frog lateral view - Non-displaced fracture of acetabulum. Medial portion of the iliac bone was not well defined. Case Photo #2 Other Studies: 5/3/10 - Left office with Dx of acetabular fx - Traumatic vs Pathologic. Sent for MRI 5/8/2010 - MRI - Mass involving R acetabulum 8x6.5x6cm with associated bone marrow edema. Medial musculature and vascular structures displaced medially. Case Photo #3 Case Photo #4 5/12/10 - Bone Scan - abnormal uptake in the R iliac bone, L femur, L humeral head and L ankle. Case Photo #5 5/12/10 - CT chest/abd/pelvis - normal other than bony processes mentioned previously. 5/12/10 - CBC normal, Differential normal, BUN/Cr normal, Calcium normal, Liver enzymes normal, Total protein elevated at 8.5. Coagulation studies normal, IGA/IGM normal. IGG elevated at 1880 Consultations: 5/17/10 - Ortho Oncology - DDx included Ewings Sarcoma, Giant Cell Tumor, Langerhans cell histiocytosis, Lymphoma, Osteosarcoma, Metastatic carcinoma. 5/21/10 - CT guided biopsy revealed plasma blastic tumor favoring multiple myeloma. SPEP - monoclonal band of IGG kappa paraprotein. Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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