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Year : 2006  |  Volume : 16  |  Issue : 4  |  Page : 931-932
Radiological quiz - musculoskeletal


Imageology Division, Regional Cancer Centre, Trivandrum 695011, Kerala, India

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Date of Submission06-Jun-2005
Date of Acceptance10-Oct-2006
 

How to cite this article:
Balaji R, Ramachandran K, Krishnakumar A S, Venugopal M. Radiological quiz - musculoskeletal. Indian J Radiol Imaging 2006;16:931-2

How to cite this URL:
Balaji R, Ramachandran K, Krishnakumar A S, Venugopal M. Radiological quiz - musculoskeletal. Indian J Radiol Imaging [serial online] 2006 [cited 2020 Jul 3];16:931-2. Available from: http://www.ijri.org/text.asp?2006/16/4/931/32388
A 17 year old male was referred to our centre with complaints of progressive swelling and pain in both forearms. He was diagnosed in June 2002 with osteosarcoma of the right proximal femur. He underwent limb conservation surgery with wide excision of the tumor and then a custom-made stainless steel prosthesis implant was carried out. Thereafter he received chemotherapy with Ifosfamide, Adriamycin, and CDDP. The patient developed an infection of the prosthesis and subsequently a disarticulation had to be performed.

Physical examination of the patient revealed clubbing of fingers, thickening and swelling in the wrists and large distal joints of both upper limbs. No other positive signs or symptoms were elicited.

Radiographs of both the forearms revealed periosteal bone deposition involving the distal diaphyses and the metaphyses of tibia, fibula, radius and ulna sparing the epiphyseal ends. The periosteal reaction had a laminated appearance with smooth layers of new bone formation and cortical thickening [Figure.1],[Figure - 2].Chest radiograph revealed soft tissue opacities in the right lower zone. [Figure - 3] CT scans showed a bulky mass with ossific density in the right lower lobe and ossific nodules in both lungs [Figure - 4].


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   References Top

1.Resnick D .Diagnosis of Joint and Bone Disorders. Vol. 5. 4th edition. pp. 4877-4485. Saunders Co, 2002  Back to cited text no. 1    
2.Flueckiger F, Fotter R, Hausegger K, Urban C .Hypertrophic osteoarthropathy caused by lung metastases of an osteosarcoma .Peditr Radiol 1989:20:128-130  Back to cited text no. 2    
3.Tarasova GV ,Shafranskii LL ,Suleimanov BN .Systemic ossifying periostoses in a patient with osteogenic sarcoma metastases to lungs .Ortop Travmatol Protez 1972:33:81-82  Back to cited text no. 3    
4.Staalman CR, Umans U .Hyprttrophic osteoarthropathy in childhood malignancy. Medical and Pediatric Oncology .1993:21:676-679  Back to cited text no. 4    
5.Daly BD. Thoracic Metastases from Nasopharyngeal Carcinoma presenting as Hypertrophic Pulmonary Osteoarthropathy: Scintigraphic and CT Findings. Clinical Radiology 1995:50:545-547  Back to cited text no. 5    

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Correspondence Address:
R Balaji
Imageology Division, Regional Cancer Centre, Trivandrum 695011, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-3026.32388

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    Figures

  [Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4]

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