Pain in the tibia and multiple bone lesions

Case Identification

Case ID Number
Benign or Malignant

Clinical case information

Case presentation

A 38-year-old woman presents with a two month history of severe pain in the right proximal tibia. Actually, the pain was maximal approximately 4 weeks ago, it has improved significantly since.

Radiological findings:
Plain radiographs show subtle sclerosis both in the distal portions of the femur, as well as the proximal tibia. MRI shows multiple lesions.
Laboratory results:
none requested.
Differential Diagnosis
She is generally healthy. She gives a history of a episode of severe dermatitis two years ago for which she took prednisone, 30 mg per day for approximately 6 weeks. The pain very focally located just below the knee, along the shaft of the proximal tibia six or 8 cm below the joint line. The examination does not show any mass. There is no erythema, redness, or visible sign of injury, bruising, or change in the skin. The pain is very focal to the area described above. Everything you need to make the diagnosis and formulate the treatment plan is in the history and images.