Pathological femur fracture

Case contributed by Vincent Tatco
Diagnosis certain

Presentation

Left knee swelling for 2 months. Severe pain after slipping.

Patient Data

Age: 15 years
Gender: Female
x-ray

There is complete fracture at the distal (metadiaphysis) femur with overriding and posteromedial displacement of the distal fracture segment. Small laterally displaced osseous fragment is also observed. The fracture margins are irregular. There are ill-defined lucencies reflective of lytic changes involving the distal shaft, metaphysis and epiphysis of the femur. Interrupted periosteal reaction (Codman triangle) is demonstrated at the distal femoral shaft above the fracture site. Lobulated soft tissue mass density is seen surrounding the fracture and effacing the adjacent fat planes.

Annotated image

Red arrow highlights the Codman triangle.

Case Discussion

This is a case of pathological fracture in a diagnosed case of osteosarcoma.

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