Clinical Cases

This 27 year old man presented with a 3 month history of swelling of the dorsum of the foot. He was healthy, working full time, and afebrile. Exam of the right foot showed a mildly tender, diffuse swelling of the area near the talus and navicular, without fluctuance or erythema. Laboratory exam was significant for a normal white cell count and an ESR of 25.

A 12 year old boy was referred from outside center following a three week history of worsening right elbow pain.In addition to the pain, the patient also had significantly reduced range of motion, and when seen in the clinic had only 20 degree range of active motion. His elbow is remarkably tender with significant effusion also.

This 11 year old girl presented to the local emergency room after she sprained her ankle in soccer. In your office 4 days later, she has local tenderness and swelling at the level of the joint line anterior to the distal part of the fibula.

Treatment for this patient consisted of 1) functional rehabilitation for the ankle sprain. 2) Observation with follow-up exams and radiographs for the tumor. See below for follow-up radiographs one year later and two years later. Click on the images for a better view.

51 year old woman with knee pain for one year

41 year old cyclist who has pain in the leg for 6 months. a biopsy of the lesion in the tibia and a CT scan of the chest was performed. What is the diagnosis?

A 42 year old man who works as a ski instructor at a ski area near Boston presents to the emergency room after suffering an injury to the right hip. He states that he was skiing through a thin layer of new snow on top of the base snow pack when his right ski caught on something, twisting his leg, at which point he felt something very painful happen to his right hip. He fell down and was unable to stand. He said he though he might have caught a "snow snake."

Case 10 An 18 year old male with leg pain

Case 9 A 58 year old woman with breast cancer. Femoral lesion detected on bone scan

Case 8 A 14 year old with recently developed pain in toe

Case 7 Leg pain in a 9 year old child

Case 6 A 28 year old man with recent onset of significant forearm pain

Case 5 A 21 year old woman with leg pain

Case 4 A 5 year old child with leg pain

Case 3 A 59 year old woman with fatigue and a mass

Case 2 A 55 year old woman with knee pain. Her son died of metastatic sarcoma at the age of 19 years

21 year old male with foot pain

The patient had an incisional biopsy, and the findings are shown. The initial treatment is shown.

A 61 year old attorney has noticed a superficial mass on the left left for about 18 months. It was totally painless but sometimes caused itching. The mass was initially thought to be a varicose vein, but slowly and progressively increased is size. On examination, a definite mass can be seen and felt.

The patient is a very pleasant woman with shoulder pain. She is 59. She has been smoking since her teenage years, approximately 40 pack years. Seven years ago, she had a painful kidney removed, and a tumor was found in the kidney which was not suspected before the operation Biopsy material is shown in the images. What is the appropriate surgical procedure?

This very pleasant gentleman is 32 and he works as a mechanical engineer. He is here because of multiple hereditary exostosis (HMOCE). His grandfather, grandmother, and two brothers are affected. He has had several surgeries for removal of osteochondromas. Most importantly, a lesion has been partially removed from the posterior left hip. This bump has now been getting bigger and more painful. Now, there appears to have been change in the left hip lesion, which appears to be larger. I have recommended surgical removal of the left hip lesion. We plan wide excision left iliac bone tumor.