Fw: Hip lesion stumper – need some input from the crowd

so only a few people weighed in.  Some focused on the presence of bilateral AVN (that wasn’t the point of the case; please look at all the images).Everyone else was concerned about the focal lytic area in the posterior femoral head (leading suspicions:  lymphoma, infection, osteoid osteoma).
Update:  Patient will be seeing orthopod for followup appointment today, and we have recommended biopsy of that area.  Since his WBC was only about 11K, I doubt infection.  My personal bet is lymphoma.  Hopefully the orthopod shares our concern and proceeds to biopsy.

—– Forwarded Message —– From: ‘Sonin Andrew’ via OCAD MSK <ocad-msk@googlegroups.com>To: OCAD <ocad-msk@googlegroups.com>Sent: Tuesday, March 30, 2021, 2:17:51 PM MDTSubject: Hip lesion stumper – need some input from the crowd
34M in ER for increasing hip pain, no trauma, no “significant underlying conditions”Powerpoint attached.