Not Your Everyday Knee Pain - Page #3

Lab Studies:
Xray of the R Knee - Normal Case Photo #1
Xray of the R Hip - AP pelvis and frog lateral view - Non-displaced fracture of acetabulum. Medial portion of the iliac bone was not well defined.Case Photo #2

Other Studies:
5/3/10 - Left office with Dx of acetabular fx - Traumatic vs Pathologic. Sent for MRI
5/8/2010 - MRI - Mass involving R acetabulum 8x6.5x6cm with associated bone marrow edema. Medial musculature and vascular structures displaced medially. Case Photo #3Case Photo #4
5/12/10 - Bone Scan - abnormal uptake in the R iliac bone, L femur, L humeral head and L ankle. Case Photo #5
5/12/10 - CT chest/abd/pelvis - normal other than bony processes mentioned previously.
5/12/10 - CBC normal, Differential normal, BUN/Cr normal, Calcium normal, Liver enzymes normal, Total protein elevated at 8.5. Coagulation studies normal, IGA/IGM normal. IGG elevated at 1880

5/17/10 - Ortho Oncology - DDx included Ewings Sarcoma, Giant Cell Tumor, Langerhans cell histiocytosis, Lymphoma, Osteosarcoma, Metastatic carcinoma.
5/21/10 - CT guided biopsy revealed plasma blastic tumor favoring multiple myeloma. SPEP - monoclonal band of IGG kappa paraprotein.

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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Leawood, KS 66211
Phone: 913.327.1415

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