Thanks so much for the replies Drs, Brandao, Umans, Guil, Staewen,
Crnkovich, Åström, and Jobke. Universally agreed that it is RA (including
by me).
This femoral diaphyseal medullary lesion is what scared me and made me
think initially that it might be a potential malignancy.
[image: RA.jpg]
Drs. Åström and Staewen gave me the following article which I think answers
it: www.ajronline.org/doi/pdf/10.2214/ajr.183.5.1831453
It makes much more sense to be all the same process (ticks only) than 2
processes (ticks and fleas), especially in a 29 y/o with this Hx.
Dr Crnkovich made the comment that we should see the whole thing before
assuming it is nothing. I have requested exactly that.
Apologies for too many images as I prevented the case from getting through
to some folks. It is now on the website so
if you haven’t joined OCADmsk.com please consider doing so. Great resource.
