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Osteosarcoma of the distal femur

Case contributed by: Dr Frank Gaillard

Presentation:

Right knee pain.

Patient Data:

Age: 17 years
Gender: Female

Knee x-ray

Modality: X-ray

Bone scan

Modality: Nuclear medicine

Delayed phase bone scan image demonstrates intense uptake in the distal right femur. A single focus of increased attenuation projects just to the right of the sternum inline with the chondral cartilage of the third rib. No other suspicious lesions identified. 

MRI knee

Modality: MRI

MRI through the lesion demonstrates a soft tissue mass completely replacing the medullary cavity and extending into the adjacent soft tissues. It is low to intermediate in signal on T1 and high on T2 weighted images. 

Distribution of osteosarcomas

Modality: Diagram

This patient went on to have surgery and an osteosarcoma was histologically confirmed. 

Post op

Modality: X-ray

A limb sparing resection has been performed. The distal femur and adjacent tibial plateau has been resected and a total knee replacement inserted. 

Case Discussion:

This case demonstrates relatively typical appearances of a bone forming osteosarcoma of the distal femur (typical location) in a 17 year old (typical age). 

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