Doctor, There's Something Wrong With My Knee Replacement - Page #3
 

Lab Studies:
ESR and CRP were within normal limits.

Other Studies:
Initial plain radiography of her left knee Case Photo #1 showed a well-positioned total knee replacement with no evidence of loosening. An ill-defined radiolucent lesion was seen in the supracondylar femur just proximal to and abutting her prosthesis. A follow-up CT scan without contrast Case Photo #2 showed a lytic lesion in the distal femur. corresponding to the radiolucent lesion seen on plain films. MRI with contrast revealed a heterogeneously enhancing, aggressive-appearing lytic lesion in the distal femoral metaphysis extending to the femoral component of the knee arthroplasty. There was evidence of cortical destruction anterolaterally with minimal extraosseous extension. CT chest/abdomen/pelvis revealed no evidence of metastatic disease.

Consultations:
She was referred to orthopedic oncology and a bone biopsy was consistent with spindle cell sarcoma and possible leiomyosarcoma.

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, 11639 Earnshaw, Overland Park, KS 66210, (913) 327-1415.
 

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Phone: 913.327.1415


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