(This question is related with orthopedics. Thanks.) A 5 years old boy is brought to the...

(This question is related with orthopedics. Thanks.)

A 5 years old boy is brought to the outpatient clinics of orthopaedics and traumatology department. The family complaints that the boy has a limping gait for a few weeks without a trauma history. The child has also some constitutional symptoms like mild fever and easy fatigability. The pelvis x ray demonstrates a lamellar type periosteal reaction on the left proximal femur. What is your differential diagnosis? Which key methods would be appropriate for a proper diagnosis? (max: 150 words)

Expert Solution

Osteosarcoma is a type of bone cancer account for more predominant pediatric cancer which can cause localized periosteal reactionespecially in long bones. The spread of cancer in the subperiosteal inflammation reaction elevates the periosteum and triggers new bone formation parallel to the shaft produces immature bone. Periosteal osteosarcoma (PO) is a variant of osteosarcoma , a rare primary malignant bone tumor. The periosteal reaction based on the number of the bone is involved by the process.

Osteomyelitis denotes an infection in a bone either acquired through the bloodstream or spreading from nearby tissue. Sometimes the infection can also begin in the bone itself due to a bone injury or pathological manifestation in bone.

It is usually difficult to diagnose between osteomyelitis and osteosarcoma. Osteomyelitis indicates changes of soft-tissue swelling, cortical tunneling, focal cancellous lysis, focal cortical resorption, and a periosteal reaction in radiography analysis. MRI also detects any pathologic changes in bone marrow and extent of infection. Osteosarcoma is identified by tumour of mass with new vaascularization and also confirmed by tumour biomarkers.

Sydney Mullin answered 1 year ago

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