HPI - One month history of pain in the right thigh, increasing in intensity.
No weight loss, no fever.
What is the most likely diagnosis?
HPI - The patient was alright 8 months ago when she gradually started to develop pain in her right leg below the knee which was sudden in onset, persistent in nature, non-radiating, worse at night, relieved with painkillers and aggravated by activity.
The pain progressive over the period of 8 months associated with swelling which appeared 4 months later below the knee, gradually increased in size, no discharge or redness.
No history of trauma, joint pains, backache, morning stiffness, swelling of 1st MTP, swelling in neck, blood in sputum, flank pains, blood in urine, dark coloured stools, fever or weight loss.
How would you manage this patient?
HPI - 57yo woman who had an XRays of her Left knee for the diagnosis of knee arthritis.
Incidental finding on the XRay was a tumor of the fibula head.
How would you manage this lesion?
HPI - The condition started six months ago after a minor twisting injury and XRays confirmed a pathologic fracture through a bone cyst in the proximal femur. The fracture was treated conservatively and completely united but the cyst persisted.
What other investigations are needed?
HPI - Patient felt a mass about 6 months ago in her left gluteal area. Diagnostic work-up with Ultrasound, CT and MRI lead to biopsy with extraosseous pleomorphic sarcoma as the result of histology. Patient is currently status post resection of the tumor, mobilised with a G apparatus. Feels instability and pain in the area of the resection.
Is reconstruction of pelvic ring warranted and if so, what kind?
HPI - 36 year old female previously presented with a history of left hip pain 3 years ago with a lytic lesion in the left intertrochantric area. She was operated on with a fixed angle plate, bone graft and biopsy.
8 months ago removal of implant was done and attached is X-Ray post removal and result of histopathology.
1 month ago, patient presented with progressive left hip pain and X-Ray is shown with a recurrent lytic lesion with extension to the femoral neck.
What is the best option of treatment?
HPI - Patient presents to the emergency room with acute left knee pain after low energy trauma.
Would you perform a needle biopsy in this patient prior to surgical intervention to confirm the diagnosis?
HPI - A 30 year old male presents with sudden onset of severe pain at the back of his right knee followed by swelling and painful range of motion after lifting a heavy object 5 days ago,
He was initially prescriped an NSAID which has not provided much relief of his symptoms.
What is your working diagnosis?
HPI - 55 year old presented with ongoing left hip pain for the last 6 months. He was prescribed NSAIDs by his local doctor which were of no use. He attended my outpatient clinic in a wheel chair, unable to weight bear due to the hip pain.
If you chose to biopsy this lesion, which approach would you use?
HPI - 45M presents with insidious onset of lower back pain and pain over his trochanteric region of the left hip. His symptoms have been progressing over the past 3 months.
The patient noted a fever of a week's duration at the onset of his symptoms, but this has resolved. Currently, no fever.
His pain is worst at night.
He notes 4kg (8.8 lbs) unintentional weight loss over the past 3 months.
No trauma. No sciatica. No cough or other constitutional symptoms.
No other joint pains, bladder or bowel symptoms, haematuria, or swelling in other parts of body.
What is the likely diagnosis?
HPI - The patient is a 42 year old male who gives a history of injury to his right buttock after sustaining a fall while playing volleyball approximately 6 months ago.
He recovered well from the initial injury and was able to run and continue training.
He subsequently developed activity-related mild right buttock pain that began about ~1 month after the initial injury.
The patient feels his current pain may be related to his previous injury.
No fever / night pain / weight loss / rest pain / systemic symptoms.
HPI - pain in the right hip since few days . no injury walking with a limp
HPI - Noticed bony swelling and deformity since two month. No pain.no fever wt loss or loss of appetite.
What is your diagnosis is the most likely diagnosis based on the information provided?
HPI - 15 year old with 4 months of anterior left knee pain. there is pain consistent with typical patellofemoral pain syndrome in an adolescent. there is pain along the medial plica region and palpable mass similar to lipoma. no constitutional symptoms or injury starting the pain. XR and MR arthrogram shown.
HPI - The patient presents with intermitten right dull hip pain for the last month.
Based on the imaging provided, and the MRI report shown (under MRI image), what is the most likely diagnosis.
HPI - Patient presents with 3 months of forearm pain and edema. There is pain with any type of motion.
How would you stabilize the radius?
HPI - parents noticed a swelling of the righ wrist around a month,no h/o fall
What is the most likely diagnosis base on the radiographs alone
HPI - Recent history of playing football since 2 weeks with no direct injury or twist.
What is the most appropriate net step investigation?
HPI - When the patient was about 3 years old the mother noticed multiple bony prominence/swelling in upper and lower limbs. The prominence/swelling were painless and slightly increased in size over time. The girl was diagnosed to have hypothyroidism and is on thyrozine therapy
What is the most likely diagnosis in your differential?
HPI - The condition started many years ago by painless swelling in the lt litlle finger with slight stiffness of the PIP. One month ago after minor trauma the condition became painful.
Based on the information provided, what is the most likely diagnosis?
HPI - Fall from standing height 3 years ago
Complaints of constant pain almost every day at the coccygeal region
The dimension of the mass is increasing with the passing time
Bone scanning ( - )
Temporary pain relief at NSAID
No local inflammation signs
WBC normal values
CRP above limit
What is the MOST LIKELY diagnosis based on the limited information provided?
HPI - Increasing pain over last few yrs with onset of swelling over last year. Pain has increased to the point that now there is pain with rest.
What do you think is the most likely diagnosis of the cyst?
HPI - Chronic pain lateral side of left leg of 3 years duration. No treatment for this problem taken to date.
what is the most likely diagnosis based on the radiographs provided?
HPI - Pain on loading right thumb fort 02 ys duration.
Gradually worsening, aggravated for 02 months
HPI - Optd in other center 04 yrs back for some calcaneal lesion - Curettage + Autologous iliac crest Bone grafting was done. (Documents, previuo radiographs and HPE report not available) .. wounds healed.
Sustained trauma to same side 01 yr back.. developed swelling laterally in hind foot. Had some discharge for a months which resolved on medications.(? antibiotics) and dressings.
Presently has swelling over the hind foot behind and below lateral malleolus (Picture for reference). Mild pain on weight bearing. No discharge.
Treatment options presently
HPI - Pain thigh for 03 months spontaneous onset, gradually progressive.
No history of trauma, fever, tuberculosis in past.
Likely diagnosis on radiographs
HPI - 17 yo male with 1 week of pain after walking at school. XR in ER are normal in first images. no constitutional symptoms. walking down steps and hears a pop in leg with pain with Xr showing displaced posterior cortex fracture and no anterior involvement. Has anyone seen a fracture pattern like this previously and any comment as to its etiology??
Is this fracture pattern suspicious for:
HPI - volume increased pain at metatarsal plantar.
What is your diagnosis?
HPI - Fall from bed and sustained fracture shaft femur left
Additional work up in this case
HPI - The pain in right hip started since 5 years. not relieved by analgesic .Pt tried local intraosseous injection of bone marrow one year ago without improvement of pain
what is the best treatment option?
HPI - incidental finding on xray. follwing which a ct scan was done
Based on xrays alone would you recommend further investigations?
HPI - Came to the ER after a road traffic accident ,general condition is good,discovered after routine x-ray
Do you need any additional imaging studies in addition to the radiographs? If so, what?
HPI - 3 weeks of pain. Limping.
Based only on the radiographs, what is the most likely diagnosis?
HPI - pain at rt leg since 4 months, gradual in on set progressive in nature,first swelling followed by pain,pain is increased on walking & relived by taking rest,no h\o trauma,fever ,wt loss,no similar complaints in the past.
what is your probable diagnosis ?
HPI - Patient had a gradually enlarging swelling over the poster medial aspect of the right distal tibia for more than one year.
Assuming the diagnosis is Giant Cell Tumor (osteoclastoma), what would be the next step in management?
HPI - He is a doctor presented with R / Hip pain for last 3 months. Temporarily responding to analgesics.
Based only on the radiographs, what is causing the patient's hip pain?
HPI - Past untreated scaphoid nonunion. Wrist pain since two years ago. Now worse.
How would you treat this case?
HPI - low back pain radiating to right knee since 6 months,
what should be the further management
HPI - Dull hip pain six months non progressive,non radiating.not restricting activities.sports participation once a week.
Based on the images provide, what is the most likely diagnosis in your differential diagnosis?
HPI - Insidious onset of dull pain on her right distal femur since two years ago. Pain has a nocturnal character and gets worse on palpation. Palpable mass since unknown time origin. Negative trauma history. Pain does not respond specifically to NSAIDS. No weight loss.
What is the best approach for biopsy?
HPI - swelling over left upper back for last 4 yrs increasing in size.first noticed by his mother.
history of fall from tree 4 yrs back about 12 feet height didnot seek any medical advice.he was asymptomatic till today except swelling which doesnot interfer with his daily activities.
what is your provisional diagnosis?
HPI - Pain of 2-3 months
What is the most likely diagnosis based on the images provided?
HPI - Swelling medial aspect of right arm. Approximate mass/swelling is 6x2 cms. No erythema or tenderness. Full range of motion of right shoulder and elbow.
What is the most likely diagnosis for this lesion based on radiographs alone?
HPI - Pain started in Rt knee .gradual swelling.
no trauma. no fever.
No other body joint involvement
What would be your next step in managment?
HPI - Otherwise healthy 6 year old boy who fell at the playground on his left elbow. He has had elbow pain since with any ROM. No prior elbow injury known.
What do you think this is?
HPI - Presents with pain in the left shoulder, initially milder and occasional but now constant and increases with activity and at NIGHT, unable to use his left arm for ADL, for the last two years.
No H/O fever, appetite or weight loss.
Underwent left shoulder Arthroscopy and biopsy two years ago in another hospital at the start of the complaints. The biopsy was reported as "nonspecific chronic inflammation and fibrosis". Was advised to do exercises post-biopsy.
Had undergone Nerve Conduction and EMG studies twice for wasting along the upper limb. These were reported as "chronic denervation potential seen" in deltoid, biceps and triceps muscles.
What is your possible Differential Diagnosis?
HPI - 8 months history of left hip pain. pain started in Winter this year and has improved in severity recently.
HPI - pain rt hip since 3 months.with pain on walking
What would be your treatment choice for this patient?
HPI - pt is c/o pain swelling rt knee for 2 months
HPI - pain in the lt knee since 8 mths. pain moderate intensity increasing while runnin
How would you treat this patient?