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Beyond The Sidelines: Persistent Atraumatic Knee Pain In A Collegiate Athlete - Page #3
 

Lab Studies:
None

Other Studies:
Case Photo #1 Plain radiographs of the left knee demonstrated a well-circumscribed cortically based radiolucent lesion with a surrounding sclerotic rim in the distal femoral metaphysis. Given the unexpected radiographic findings, MRI of the left knee was obtained.
Case Photo #2 Case Photo #3 MRI demonstrated an osteolytic lesion with cortical breakthrough, periosteal reaction, and surrounding marrow edema concerning for a locally aggressive bone lesion.

Consultations:
Due to the aggressive imaging appearance, orthopedic oncology was consulted. The imaging differential diagnosis included giant cell tumor, chondromyxoid fibroma, aneurysmal bone cyst, and chondroblastoma.
Image-guided core biopsy demonstrated a giant cell-rich lesion. Given the age of the patient, the lesion location, cortical breakthrough, and giant cell-rich histology, giant cell tumor became the leading working diagnosis preoperatively. However, the biopsy findings were not entirely specific. Multiple benign and locally aggressive bone tumors may demonstrate multinucleated giant cells on limited sampling, and definitive classification often requires evaluation of the full surgical specimen.

Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.

NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.
 

UPCOMING EVENTS


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11/19-11/22/2026
2026 AMSSM/OHSU Introductory &/or Diagnostic/Interventional Sports US Course

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12/04-12/06/2026
2026 Advanced Team Physician Course

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4/16-4/21/2027
2027 AMSSM Annual Meeting

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