I received two after hours responses raising concern that this could be an early osteosarcoma, urging close clinical and imaging follow up.I was advised that clinical details would be important….to know when the XRs were obtained and whether the child has been actively engaged in sports or not in recent weeks .
The XRs were obtained 16 days prior to the MRI.
The referring sports orthopedist advised my colleague that the patient has been actively engaged in all sports (softball, basketball, football, soccer) and has not rested at all…that she has pain with certain movements.
The patient will be referred to an orthopedist with pediatric and tumor training / experience in NYC, so she will not fall through the cracks.
We will endeavor to get follow up even if her future imaging is obtained elsewhere
Hilary
On Wed, Dec 20, 2023 at 11:02 AM hilary umans <hilary.umans> wrote:
(abnormality medial humeral metadiaphysis visible in AP view only)
This is a consult from my colleague Jonathan Sterman
The lesion kind of looks like a fibrous cortical defect on MRI, but that doesn’t explain either the marrow edema or the subperiosteal resorption (is that what it is?) on XR
If this were at the medial supracondylar femur, I might think of a tug lesion….a la the terribly misnamed cortical desmoid
I’ve never seen a tug lesion here
We’re holding the report awaiting your advice….
Thank you
