A 17 year old male with 3 months symptoms referable to th right hip

[kenneth masamaro]

A 17-yr-old male presented with 3 months of symptoms referable to the right hip. Nocturnal pain was the predominant symptom and was promptly relieved with diclofenac therapy. On examination, the right hip showed moderate global restriction in range of motion. The erythrocyte sedimentation rate, rheumatoid factor status and full blood examination were normal. An X-ray revealed a 1-cm lucency in the right femoral neck. A bone scan revealed increased uptake in the right femoral neck, with no uptake elsewhere. A computed tomography (CT) scan showed a 7-mm lytic lesion anteriorly in the right femoral neck.

Which of the folowing is the likely diagnosis;

A.Osteochondroma
B.Osteoblastoma.
C.Osteoid osteoma.
D.Osteoma
E.Osteogenic sarcoma.

[bharat]

The most likely diagnosis is E.Osteogenic sarcoma.let us see what is the response?????

[kenneth masamaro]

Originally Posted by bharat

The most likely diagnosis is E.Osteogenic sarcoma.let us see what is the response?????

The Correct answer is osteiod osteoma.Osteoid osteoma has a very distinct presentation.It is a benign tumour of bone that accounts for 10% of bone tumours.Usually presnts at the ages of 10-25 years and affects males twice more than females.It is characterized by pain that is usually nocturnal or severe at this time and is promptly relieved by NSAIDS.(in this patient diclophenac)It has a predilection for the appendicalar skeleton- typically proximal femur and diaphysis of long bones.Radiographic studies show radiolucent nidus sorrounded by a sclerotic area on the bony cortex.

Osteoblastoma affects more of the spine.The pain is not relieved by NSAIDS.For osteogenic sarcoma the more common sites are the knee while the mass rapidly expands and again the pain is not reilved spontaneously by the drugs.