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Case: Symptoms and Presentation

A 90 year old woman with 3 weeks of foot pain

This delightful 90-year-old woman has pain in the right foot, in the midfoot at the base of the second and third metatarsals. There is a lesion on the x-rays and on the MRI in that area. The patient has a history of nephrectomy for renal cell carcinoma 6 years ago.

A 55 year old Greek woman with foot pain and a bone lesion

The patient is a 55 y.o female with pain on the base of the 1st metatarsal. She has difficulty on weight bearing leading to an antalgic gait.

A 36 year old woman with a "thick foot"

This active and fit 36 year old woman has been practicing mixed martial arts and kickboxing. She says her right foot has been "thick" and swollen for about 6 months.

Calcifications in the flexor hallucis brevis

This generally healthy 36-year-old woman has calcifications in the tissues plantar to the first metatarsal. There is no history of injury.

A mysterious lesion in the tibia

This healthy and active 56 year old woman has a painless lesion in the distal tibia. The lesion was discovered on an MRI that was performed for unrelated foot pain. The lesion is totally invisible on the xray, but easily seen on the MRI.

Frozen shoulder or something else?

The patient is a 62-year-old woman who is seen because of a mass in the right shoulder. She states that her symptoms began approximately two years ago, with stiffness. She had limited motion and was told that she might have a frozen shoulder.

That's Gotta Hurt! A painless mass in the thigh

The patient is a very pleasant 86 y/o woman. She says there is absolutely no pain in the thigh She denies any weakness in the right leg. She feels fine, and her appetitie is good, but she has lost 15 lbs in the past few months. Examination of the thigh shows normal mobility of the hip and normal mobility of the knee, and the strength in the two legs is roughly equal.

A painful skin lesion next to the toenail

The patient has a painful skin lesion on the dorsolateral surface of the left second toe, adjacent to the base of the left second toenail. The lesion does not have any visible pigmentation. It has a raised, red, scaly appearance with the overlying skin coming off in small flakes. It has been present at least one year, with slow growth.

A lesion in the talus of an 88 year old woman with 2 previous tumors

This 88 year old woman has dementia, left ankle pain, and a lesion in the left talus. There was treatment for two different tumors approximately 10 years ago, but further details are not available. The local exam shows swelling and tenderness, but no redness, no old incisions or scars,and moderate tenderness generalized around the ankle. The patient is afebrile.

A young man with a worrisome tibial lesion

This 18 year old male has pain in the shin for 4 months. The pain is exacerbated by his ongoing training for the "iron man" competition. Examination of the tibia shows there slight point tenderness, but no mass or swelling. No regional lymphadenopathy. Knee exam is normal.