Lab Studies:
CBC, CMP, lipid panel, CK, TSH, ESR, CRP, RF, vitamin D 25-OH, tissue transglutaminase antibody and IgA, all within normal limits. Lyme antibody and ANA negative.
Other Studies:
5/2017: X-ray left femur - read as normal per radiology
<br>6/2017: X-ray lumbar spine - normal lumbar spine; left proximal femoral mass and bilateral femoroacetabular impingement <a href="CaseStudyImages/CS1FemoroacetabularI-775.jpg" title="Case Photo #1" data-lity><b>Case Photo #1</b></a>
<br>8/2017: Bone scan left proximal femur - positive; MRI left femur - 10cm femoral mass
<br>9/2017: Biopsy of left femur - consistent with chronic and acute inflammation and blood
<br>12/2017: X-ray left femur - stable from prior
<br>3/2018: MRI left femur - expanding lesion disrupting cortex <a href="CaseStudyImages/CS2CS1Femoroacetabul-775.jpg" title="Case Photo #2" data-lity><b>Case Photo #2</b></a>
<br>3/2018: Open biopsy of left femoral mass - consistent with inflammation and blood
<br>4/2018: Curettage of femoral lesion - consistent with Langerhans cell histiocytosis
Consultations:
Orthopedic oncology
Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.