Published in:
01-09-2012 | Orthopaedic Case of the Month
A 16-year-old Boy with Multifocal, Painless Osseous Lesions
Authors:
Ellen M. Dean, MD, James C. Wittig, MD, Camilo Vilalobos, MD, Roberto A. Garcia, MD
Published in:
Clinical Orthopaedics and Related Research®
|
Issue 9/2012
Login to get access
Excerpt
A 16-year-old boy presented with left wrist pain of 8 months’ duration. There was a remote history of a hyperextension injury to the wrist while weight lifting. He denied all constitutional symptoms. He had taken NSAIDs intermittently with no resolution of symptoms. He was an otherwise healthy adolescent with no significant medical history. His family history was noncontributory. The patient had been seen by an orthopaedist who suspected triangular fibrocartilage complex (TFCC) tear and ordered MRI without contrast. The MRI showed several well-defined intramedullary lesions in the distal radius and carpal bones that were suggestive of leukemia. The orthopaedist then obtained a bone marrow biopsy which showed normocellular marrow with trilineage hematopoiesis and no evidence of acute leukemia. The patient then was referred for orthopaedic oncology evaluation for additional workup of the lesions seen on the MR images. …
