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11 year old girl with left ankle sprain

Case Identification
Case ID Number: 
20091105ER
Periosteal Reaction: 
absent
Benign/Malignant: 
unknown
Clinical case information
Case presentation: 

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.

Radiological findings:: 
The lesion is still present, but no growth or progression has occurred. Longitudinal growth of the bone has made the lesion seem to move away from the growth plate. The lesion shows no evidence of progression or aggressive behavior. It seems to have become smaller, but this is likely to be due to relative increase in size of the tibia due to continued growth. The lesion seems to have moved farther away from the growth plate. This lesion is likely to involute after skeletal maturity
Special Features of this Case:: 
In this case, it was felt that the tumor had no causal relationship with the sprained ankle, and that this lesion did not pose a threat of pathological fracture that was high enough to warrant surgical treatment. The patient was allowed to continue to play soccer and participate fully in gym class.
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