Other Pathology Topics - Pathology

(SAE07PE.9) A 13-year-old girl is referred for a painful progressive valgus deformity of the right knee. Examination reveals an antalgic gait with an obvious valgus deformity. The right distal femur has a palpable, tender mass with erythema and warmth. Figures 4a and 4b show a clinical photograph and a radiograph. Management should consist of Review Topic

QID: 6069

FIGURES:

A
B

1

needle biopsy of the distal femur.

21%

(16/77)

2

open reduction and internal fixation with a locking plate.

1%

(1/77)

3

closed reduction and fixation with a reamed antegrade locking intramedullary nail.

1%

(1/77)

4

referral to an orthopaedic oncologist for staging studies, biopsy, and definitive management.

70%

(54/77)

5

IV antibiotics for 6 weeks.

3%

(2/77)

ML 3

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PREFERRED RESPONSE 4

(SAE07PE.22) A 15-year-old boy has a mass at the knee. Radiographs show an aggressive tumor involving the proximal tibia, and biopsy findings reveal a high-grade osteosarcoma. Staging studies show that the tumor impinges on the neurovascular bundle. The tumor enlarges during preoperative chemotherapy. Management should now consist of Review Topic

QID: 6082

1

prolonged chemotherapy.

0%

(0/9)

2

radiation therapy.

0%

(0/9)

3

amputation.

67%

(6/9)

4

marginal excision, sparing the neurovascular bundle.

0%

(0/9)

5

wide excision, including the neurovascular bundle.

22%

(2/9)

N/A

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PREFERRED RESPONSE 3

(SAE07PE.32) What is the most common primary malignant bone or cartilage tumor in children? Review Topic

QID: 6092

1

Ewing’s sarcoma

16%

(3/19)

2

Giant cell tumor

0%

(0/19)

3

Osteosarcoma

58%

(11/19)

4

Chondrosarcoma

0%

(0/19)

5

Osteochondroma

21%

(4/19)

N/A

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PREFERRED RESPONSE 3