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eccentric

An aggressive tumor in the distal femur

Case Identification
Case ID Number: 
20090728AT
Periosteal Reaction: 
present
Benign/Malignant: 
unknown
Clinical case information
Case presentation: 

A 27 year old man has 14 month history of knee pain that was minor at first and accompanied by low grade fevers. After several months, warmth and swelling in the knee developed and an xray was taken.

Radiological findings:: 
See images

An unusual cartilage lesion

Case Identification
Case ID Number: 
20090724UC
Periosteal Reaction: 
absent
Benign/Malignant: 
unknown
Clinical case information
Case presentation: 

A 67 year old woman has knee pain, and xrays that show a lesion has developed in a previously normal part of her distal femur sometime over the last two years.

Radiological findings:: 
An eccentric lesion with some features that are reassuring, but others that are worrisome. There appears to be thinning or break-through of the cortex.
Pathology results:: 
Biopsy results are shown. What is the diagnosis?
Treatment Options:: 
What is the best treatment option?
Image Reference: 

Avulsive cortical irregularity - "tug lesion"

Tug lesion, also known as avulsive cortical irregularity is an overuse injury that occurs in the knees of children. It can be mistaken for a tumor.
Children between 11 and 14, depending on bone age, get this lesion.
Symptoms are knee pain with athletic activityOn xrays, at the distal posterior medial end of the femur, just above the growth plate, a cortical irregularity is seen.
Treatment is rest and observation

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Chondromyxoid Fibroma

Chondromyxoid fibroma (CMF) is a rare benign cartilage tumor that mostly occurs in children.
This tumor occurs mostly in teenagers
Patients feel slowly increasing pain and a massOn the xray, an eccentric, lytic lesion appears in the metaphysis
Curettage is the treatment of choice for most of these tumors.

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