Osteosarcoma - distal femur

Case contributed by Assoc Prof Frank Gaillard

Presentation

Knee pain.

Patient Data

Age: 14 years
Gender: Female
x_ray

A illdefined lucent lesion involves the metaphysis and distal diaphysis of the femur. It does not appear to quite reach the growth plate. Laterally the mass elevates the cortex with periosteal reaction (Codman triangle).

Nuclear medicine

Delayed images of a bone scan demonstrate the femoral lesion to have increased activity. No other lesions evident. 

mri

Selected coronal and axial images through the femoral tumor demonstrate enhancement and extension beyond the cortex with enhancement and edema involving the adjacent soft tissues. 

Case Discussion

Multi-modality imaging is characteristic of an osteosarcoma of the distal femur which was subsequently histologically proven.

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