Hi again Ocaders,
Thank you for all received 2nd opinions:) Very helpful!
From 6 received opinions:
2x for CRMO
2x for extensive FOPE
2x for hypovitaminosis C (or D)
I’ve added them all in ddx with a follow-up recommendation.
Nobody went for OM which is reasonable as no symptoms of infection were present clinically – only pain.
After a thoughtful next-day review of the case, I started to favour CRMO slightly.
For extensive FOPE I’d expect more BME also on the other side of physis (epiphysis) as it should be centred around a small bridging point in the physis.
For hypovitaminosis, I’d expect also the involvement of other visualised bones (tibia, fibula). Apologise for not including the fibula in the sent screenshots. I also don’t have a contralateral knee for comparison.
It was a difficult case. In case of feedback from a clinician, I’ll share it with you.
Kind regards,
Kamil
Hi Ocaders,
I’d like to have a 2nd opinion from you on the following case.
12 boy with right knee pain since 2 months started after walking. No trauma. Pain more on the lateral side with flexion. No fever or sweating.
BME mostly in femoral metaphysis along physis. Little BME is also in LFC.
I’m considering extensive FOPE, OM or CRMO.
MRI right knee images:
Coronals: T1 and PD FS
Sagittals: PD FS and PD
Happy to hear your thoughts.Cheers,
Kamil
