PATHOLOGICAL FRACTURE LEG
CHERRY KOVOOR
Dear Friends
Requesting your opinion
35 yr old man- manual labourer treated elsewhere
Pt had some pain Feb 2020 R leg for which and x-ray taken showed some lesion. Was advised biopsy which the pt refused. Had a fracture in July 2020 which was treated in cast after aspiration which showed a few leukocytes. United in cast and was going about his work. 2days ago [16/6/2021] had another fall and another fracture through the lesion.
Blood test - normal
My question is what could be the lesion, My plan is first get a biopsy and depending on the result proceed further
Attaching serial x-rays
With regards
DR CHERIYAN KOVOOR
KOCHI INDIA
Alexander Chelnokov
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Alexander N. Chelnokov
Dr Minoo Patel
Hi Cherry,
Its diaphyseal and has a soap bubble appearance and has seemingly healed once, though I suspect the fracture had never fully healed.
Simple bone cyst or aneurysmal bone cyst
Needs a tissue diagnosis
If it’s a SBC or ABC the fracture will likely cause partial healing of the lesion, though it’ll need a prophylactic nailing in SBC and
Injection with steroid or absolute alcohol or calcitonin initially for ABC, followed by nailing (risk of metastasis).
Good luck
Minoo
Prof. Minoo Patel MBBS, MS, FRACS, Ph.D.
Orthopaedic Surgeon
Adjunct Professor, RMIT University ǀ Senior Lecturer Monash University ǀ Research Fellow Melbourne University
Director and Past Chair, Australian Orthopaedic Association Research Foundation
Suite 5.7. The Epworth Centre, 32 Erin St, Richmond. VIC 3121
Ph: 03 9429 8084 Fax: 03 94294045 Mobile: 0418 418 728
Email: minoo...@bigpond.com
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CHERRY KOVOOR
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