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Published in: Clinical Orthopaedics and Related Research® 6/2009

01-06-2009 | Orthopaedic • Radiology • Pathology Conference

Orthopaedic · Radiology · Pathology Conference: Thigh Pain in a 53-year-Old Woman

Authors: Joseph J. King, MD, J. Stuart Melvin, MD, O. Hans Iwenofu, MD, Edward J. Fox, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 6/2009

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Excerpt

A 53-year-old woman presented with 3 months of progressively worsening right medial thigh pain. She reported having constant severe pain and a burning sensation in the upper thigh. Her pain was worse at night, often awakening her from sleep. Initially, she experienced some relief with aspirin, ibuprofen, and naproxen; however, these no longer provided relief. She obtained partial pain relief with acetaminophen. She had a history of mild, blunt trauma to the left torso approximately 1 month before presentation, but no history of trauma to the affected limb. She denied any back pain, fever, chills, night sweats, or weight loss. …
Literature
1.
go back to reference Arico M. Langerhans cell histiocytosis in adults: more questions than answers?. Eur J Cancer. 2004;40:1467–1473.PubMedCrossRef Arico M. Langerhans cell histiocytosis in adults: more questions than answers?. Eur J Cancer. 2004;40:1467–1473.PubMedCrossRef
2.
go back to reference Azouz EM, Saigal G, Rodriguez MM, Podda A. Langerhans’ cell histiocytosis: pathology, imaging and treatment of skeletal involvement. Pediatr Radiol. 2005;35:103–115.PubMedCrossRef Azouz EM, Saigal G, Rodriguez MM, Podda A. Langerhans’ cell histiocytosis: pathology, imaging and treatment of skeletal involvement. Pediatr Radiol. 2005;35:103–115.PubMedCrossRef
3.
go back to reference Binkovitz LA, Olshefski RS, Adler BH. Coincidence FDG-PET in the evaluation of Langerhans’ cell histiocytosis: preliminary findings. Pediatr Radiol. 2003;33:598–602.PubMedCrossRef Binkovitz LA, Olshefski RS, Adler BH. Coincidence FDG-PET in the evaluation of Langerhans’ cell histiocytosis: preliminary findings. Pediatr Radiol. 2003;33:598–602.PubMedCrossRef
4.
go back to reference Bunch WH. Orthopedic and rehabilitation aspects of eosinophilic granuloma. Am J Pediatr Hematol Oncol. 1981;3:151–156.PubMedCrossRef Bunch WH. Orthopedic and rehabilitation aspects of eosinophilic granuloma. Am J Pediatr Hematol Oncol. 1981;3:151–156.PubMedCrossRef
5.
6.
go back to reference Dogan AS, Conway JJ, Miller JH, Grier D, Bhattathiry MM, Mitchell CS. Detection of bone lesions in Langerhans cell histiocytosis: complementary roles of scintigraphy and conventional radiography. J Pediatr Hematol Oncol. 1996;18:51–58.PubMedCrossRef Dogan AS, Conway JJ, Miller JH, Grier D, Bhattathiry MM, Mitchell CS. Detection of bone lesions in Langerhans cell histiocytosis: complementary roles of scintigraphy and conventional radiography. J Pediatr Hematol Oncol. 1996;18:51–58.PubMedCrossRef
8.
go back to reference Favara BE, Feller AC, Pauli M, Jaffe ES, Weiss LM, Arico M, Bucsky P, Egeler RM, Elinder G, Gadner H, Gresik M, Henter JI, Imashuku S, Janka-Schaub G, Jaffe R, Ladisch S, Nezelof C, Pritchard J. Contemporary classification of histiocytic disorders. The WHO Committee On Histiocytic/Reticulum Cell Proliferations. Reclassification Working Group of the Histiocyte Society. Med Pediatr Oncol. 1997;29:157–166.PubMedCrossRef Favara BE, Feller AC, Pauli M, Jaffe ES, Weiss LM, Arico M, Bucsky P, Egeler RM, Elinder G, Gadner H, Gresik M, Henter JI, Imashuku S, Janka-Schaub G, Jaffe R, Ladisch S, Nezelof C, Pritchard J. Contemporary classification of histiocytic disorders. The WHO Committee On Histiocytic/Reticulum Cell Proliferations. Reclassification Working Group of the Histiocyte Society. Med Pediatr Oncol. 1997;29:157–166.PubMedCrossRef
9.
go back to reference Garg S, Mehta S, Dormans JP. Langerhans cell histiocytosis of the spine in children: long-term follow-up. J Bone Joint Surg Am. 2004;86:1740–1750.PubMed Garg S, Mehta S, Dormans JP. Langerhans cell histiocytosis of the spine in children: long-term follow-up. J Bone Joint Surg Am. 2004;86:1740–1750.PubMed
10.
go back to reference Geevasinga N, Jeremy R, Crombie CM, Manolios N. Histiocytosis and bone: experience from one major Sydney teaching hospital. Intern Med J. 2005;35:622–625.PubMedCrossRef Geevasinga N, Jeremy R, Crombie CM, Manolios N. Histiocytosis and bone: experience from one major Sydney teaching hospital. Intern Med J. 2005;35:622–625.PubMedCrossRef
11.
go back to reference Ghanem I, Tolo VT, D’Ambra P, Malogalowkin MH. Langerhans cell histiocytosis of bone in children and adolescents. J Pediatr Orthop. 2003;23:124–130.PubMedCrossRef Ghanem I, Tolo VT, D’Ambra P, Malogalowkin MH. Langerhans cell histiocytosis of bone in children and adolescents. J Pediatr Orthop. 2003;23:124–130.PubMedCrossRef
12.
go back to reference Islinger RB, Kuklo TR, Owens BD, Horan PJ, Choma TJ, Murphey MD, Temple HT. Langerhans’ cell histiocytosis in patients older than 21 years. Clin Orthop Relat Res. 2000;379:231–235.PubMedCrossRef Islinger RB, Kuklo TR, Owens BD, Horan PJ, Choma TJ, Murphey MD, Temple HT. Langerhans’ cell histiocytosis in patients older than 21 years. Clin Orthop Relat Res. 2000;379:231–235.PubMedCrossRef
13.
go back to reference Kilpatrick SE, Wenger DE, Gilchrist GS, Shives TC, Wollan PC, Unni KK. Langerhans’ cell histiocytosis (histiocytosis X) of bone: a clinicopathologic analysis of 263 pediatric and adult cases. Cancer. 1995;76:2471–2484.PubMedCrossRef Kilpatrick SE, Wenger DE, Gilchrist GS, Shives TC, Wollan PC, Unni KK. Langerhans’ cell histiocytosis (histiocytosis X) of bone: a clinicopathologic analysis of 263 pediatric and adult cases. Cancer. 1995;76:2471–2484.PubMedCrossRef
14.
go back to reference Lieberman PH, Jones CR, Steinman RM, Erlandson RA, Smith J, Gee T, Huvos A, Garin-Chesa P, Filippa DA, Urmacher C, Gangi MD, Sperber M. Langerhans cell (eosinophilic) granulomatosis: a clinicopathologic study encompassing 50 years. Am J Surg Pathol. 1996;20:519–552.PubMedCrossRef Lieberman PH, Jones CR, Steinman RM, Erlandson RA, Smith J, Gee T, Huvos A, Garin-Chesa P, Filippa DA, Urmacher C, Gangi MD, Sperber M. Langerhans cell (eosinophilic) granulomatosis: a clinicopathologic study encompassing 50 years. Am J Surg Pathol. 1996;20:519–552.PubMedCrossRef
15.
go back to reference Olschewski T, Seegenschmiedt MH. Radiotherapy of Langerhans’ cell histiocytosis: results and implications of a national patterns-of-care study. Strahlenther Onkol. 2006;182:629–634.PubMedCrossRef Olschewski T, Seegenschmiedt MH. Radiotherapy of Langerhans’ cell histiocytosis: results and implications of a national patterns-of-care study. Strahlenther Onkol. 2006;182:629–634.PubMedCrossRef
16.
go back to reference Pavlik M, Bloom DA, Ozgonenel B, Sarnaik SA. Defining the role of magnetic resonance imaging in unifocal bone lesions of langerhans cell histiocytosis. J Pediatr Hematol Oncol. 2005;27:432–435.PubMedCrossRef Pavlik M, Bloom DA, Ozgonenel B, Sarnaik SA. Defining the role of magnetic resonance imaging in unifocal bone lesions of langerhans cell histiocytosis. J Pediatr Hematol Oncol. 2005;27:432–435.PubMedCrossRef
17.
go back to reference Schaub T, Ash JM, Gilday DL. Radionuclide imaging in histiocytosis X. Pediatr Radiol. 1987;17:397–404.PubMedCrossRef Schaub T, Ash JM, Gilday DL. Radionuclide imaging in histiocytosis X. Pediatr Radiol. 1987;17:397–404.PubMedCrossRef
18.
go back to reference Schreuder HW, Pruszczynski M, Lemmens JA, Veth RP. Eosinophilic granuloma of bone: results of treatment with curettage, cryosurgery, and bone grafting. J Pediatr Orthop B. 1998;7:253–256.PubMed Schreuder HW, Pruszczynski M, Lemmens JA, Veth RP. Eosinophilic granuloma of bone: results of treatment with curettage, cryosurgery, and bone grafting. J Pediatr Orthop B. 1998;7:253–256.PubMed
19.
go back to reference Stull MA, Kransdorf MJ, Devaney KO. Langerhans cell histiocytosis of bone. Radiographics. 1992;12:801–823.PubMed Stull MA, Kransdorf MJ, Devaney KO. Langerhans cell histiocytosis of bone. Radiographics. 1992;12:801–823.PubMed
20.
go back to reference Willman CL, Busque L, Griffith BB, Favara BE, McClain KL, Duncan MH, Gilliland DG. Langerhans’-cell histiocytosis (histiocytosis X): a clonal proliferative disease. N Engl J Med. 1994;331:154–160.PubMedCrossRef Willman CL, Busque L, Griffith BB, Favara BE, McClain KL, Duncan MH, Gilliland DG. Langerhans’-cell histiocytosis (histiocytosis X): a clonal proliferative disease. N Engl J Med. 1994;331:154–160.PubMedCrossRef
21.
go back to reference Yasko AW, Fanning CV, Ayala AG, Carrasco CH, Murray JA. Percutaneous techniques for the diagnosis and treatment of localized Langerhans-cell histiocytosis (eosinophilic granuloma of bone). J Bone Joint Surg Am. 1998;80:219–228.PubMed Yasko AW, Fanning CV, Ayala AG, Carrasco CH, Murray JA. Percutaneous techniques for the diagnosis and treatment of localized Langerhans-cell histiocytosis (eosinophilic granuloma of bone). J Bone Joint Surg Am. 1998;80:219–228.PubMed
22.
go back to reference Yu RC, Chu C, Buluwela L, Chu AC. Clonal proliferation of Langerhans cells in Langerhans cell histiocytosis. Lancet. 1994;343:767–768.PubMedCrossRef Yu RC, Chu C, Buluwela L, Chu AC. Clonal proliferation of Langerhans cells in Langerhans cell histiocytosis. Lancet. 1994;343:767–768.PubMedCrossRef
Metadata
Title
Orthopaedic · Radiology · Pathology Conference: Thigh Pain in a 53-year-Old Woman
Authors
Joseph J. King, MD
J. Stuart Melvin, MD
O. Hans Iwenofu, MD
Edward J. Fox, MD
Publication date
01-06-2009
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 6/2009
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-008-0363-8

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