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A 14-year-old child is referred to your office for evaluation of a tibia lesion found incidentally after a minor ankle injury. A radiograph of the child's ankle is shown in Figure A. What treatment do you suggest?
Endocrine consultation secondary to associated endocrine abnormalities
Surgical consultation secondary to associated gastrointestional cancers
Short leg cast and non-weight bearing for a minimum of 6 weeks
Open biopsy and tumor staging
Routine followup of tibial lesion
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You are asked to see an 16-year-old patient by his pediatrician after a lesion is found in the child's distal fibula by radiographs taken for a sprained ankle (Figure A). The child is otherwise healthy, active, and has no pain or limitation of motion. Your management should consist of:
Non-weight bearing short leg cast
Tumor staging including chest CT, bone scan, MRI of entire bone
Contacting local child protective services
Activities as tolerated, repeat radiographs in 3 to 6 months
Curettage and allograft bone packing to lesion.
A 6-year-old boy falls off the monkey bar and presents to the emergency room with an abrasion on his knee and mild knee pain. He is able to bear weight without discomfort and has full range of knee motion. A plain radiograph is shown in Figure A. What is the most appropriate next step in management?
CBC, ESR, CRP with bone aspiration for gram stain and culture
Biopsy with neoadjuvant chemotherapy followed by limb salvage surgical resection and adjuvant chemotherapy
Repeat radiographs in 3 months
Biopsy with external beam irradiation followed by limb salvage surgical resection
MRI and CT scan of the chest
An 18-year-old male presents with leg pain after tripping during a soccer game. He has no history of leg pain or trauma. Which of the following is the most likely diagnosis and recommended treatment for the finding seen in his radiograph in figure A?
Enchondroma, surgical biopsy
Nonossifying fibroma, observation
Nonossifying fibroma, surgical biopsy
Aneurysmal bone cyst, curettage and bone grafting
A 20-year-old man falls while skiing and complains of knee pain. When he presents to the office 2 weeks later his physical exam is normal and his pain has resolved. Radiographs are shown in Figures A & B. What is the next most appropriate step in management?
Reassurance and weightbearing as tolerated
Wide resection and reconstruction
A 9-year-old boy injures his ankle while jumping on a trampoline and cannot bear weight on the extremity. A radiograph taken in the emergency room is displayed in Figure A. A biopsy of this lesion would most likely be consistent with which of the following histology slides?