Doctor, There's Something Wrong With My Knee Replacement

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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.		Back
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