Case Identification
Case ID Number
Tumor Type
Body region
Position within the bone
Periosteal reaction
Benign or Malignant
Clinical case information
Case presentation
The patient is 25. She was found to have Still’s disease, and treatment consisted of prednisone, with gradually escalating doses, ultimately culminating in a dosage of up to 70 mg daily, continuing for about 3 months.
Radiological findings:
The patient is here today because of pain in the ankles. She has pain with activity. She has swelling with activity.
There is good range of motion of both ankles, normal alignment, good circulation, normal neurovascular status, subtalar joint motion is intact. Palpation elicits pain mostly over the distal tibia on both sides and over the anterior neck of the talus bone on both sides.
X-rays of the ankles are made today on both sides, and AP and lateral view. There is normal smooth joint space, normal subchondral density without apparent collapse, no subchondral sclerosis, and no subchondral lucency.
The MRIs tell a very different story. There is extensive bilateral multifocal lesions in the talus bone, calcaneus, navicular, and this pattern of other areas of the foot bilaterally. The distal tibia and distal femur also have large areas of abnormal appearance.
There is good range of motion of both ankles, normal alignment, good circulation, normal neurovascular status, subtalar joint motion is intact. Palpation elicits pain mostly over the distal tibia on both sides and over the anterior neck of the talus bone on both sides.
X-rays of the ankles are made today on both sides, and AP and lateral view. There is normal smooth joint space, normal subchondral density without apparent collapse, no subchondral sclerosis, and no subchondral lucency.
The MRIs tell a very different story. There is extensive bilateral multifocal lesions in the talus bone, calcaneus, navicular, and this pattern of other areas of the foot bilaterally. The distal tibia and distal femur also have large areas of abnormal appearance.
Special Features of this Case:
What is the diagnosis? What should be done?
Image
Case ID Number
Image Types
Image modality
Tumor Name
Tumor Type
Benign or Malignant
Body region
Bone name
periosteal reaction
