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Case: Symptoms and Presentation

Distal femoreal resection and replacement for fibrosarcoma

This 70 year old patient has a right distal femoral fibrosarcoma in the setting of Paget's disease (post-Paget sarcoma). Distal femoral resection and replacement is performed.

A woman with right knee pain

A very pleasant 70 year old woman who has Padget's disease, a history of liver failure, and right knee pain with a worrisome mass in the distal femur.

A slowly growing mass in the tibialis anterior tendon

This 42 year old woman is quite heavy. She has noticed a gradually enlarging swelling in the front of her right ankle.

A Cartilage Mass in the mid foot

A 78 year old man has a slowly growing, slightly painful, palpable nodular mass in the TMT joint of the 1st ray.

A smoker with a painful kidney and a shoulder tumor

The patient is 59, and she has a 40 pack years smoking history. Seven years ago, she had a painful kidney removed, and a tumor was found in the kidney.

On examination, the left upper extremity is in a sling. The patient cannot really move the arm outside of the sling. No mass is felt around the shoulder at all, and there is no swelling of the affected bone.

Extensive pelvic metastasis from thyroid cancer

This patient has had pelvic metastasis from thyroid carcinoma for 6 years. He has had multiple episodes of radiation therapy, with the total dose to the left hemipelvis and of the right hemipelvis in excess of 10,000 centigray.

A lytic lesion in the distal humerus

This 60-year-old right handed woman has had gradual onset of pain in the right elbow. X-rays show a destructive bone lesion in the distal humerus. Further radiographic evaluation has shown that there is a 6.9 cm mass in the lower pole of the left kidney. It has a heterogeneous appearance consistent with renal cell carcinoma. The bone scan shows multiple areas of abnormality, including two lesions in the skull.

Calculate fracture risk

This very pleasant 55-year-old woman has a lump in the left breast and pain in the left hip. She found the breast mass 1 year ago, and it has gotten larger. She first noticed gradually increasing pain in the left groin 8 or 9 months ago. Now, the patient cannot walk without crutches. She has extreme pain with certain activities, and is taking large doses of narcotic pain medicines.

Large Shoulder Mass

The patient is 66, he has a slightly painful swelling on the lateral aspect of the right shoulder for at least one year. Now, the mass has become quite large, and there is pain in the right shoulder.
The patient has not been caring for himself well and has not seen a doctor or a dentist in quite some time. However, has not had any fevers or chills or systemic symptoms. There has been no unplanned weight loss.

Crooked Ankles

This man is 32 and works as a mechanical engineer. He is here because of painful ankles. His grandfather, grandmother, and two brothers also had similar problems. He has had several surgeries for bone problems, including a shoulder on the right when he was 12, surgeries on both tibias when he was 16, a surgery on his foot when he was 25 and another surgery on the knee when he was 26.