X ray Of the week # 5

Biopsy proven case of GCT with pathological fracture in 19 yr old male
Suggest ideal management for this patient...

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X ray of the week #4

Whats ur Dx?

Xray of the week‎ case: 3

2months back Xrays

Present X rays

A55 year old man presented to Emergency OPD with complaints of pain in his Rt hip region since last 2 months swelling in his hip and Rt lower limb since last one week.

HOPI: Patient was alright 2 months back  when he gives history of fall n injury to Rt hip region.Patient was able to get up and bear weight over his Rt lower limb following the event. patient is experiencing pain in his right hip since the event which was mild aching to start which gradually progressed to present severe excruciating pain.

Pain is associated with swelling initially localized to Rt hip region which progressed to entire Rt Lower limb

Patient is unable to walk and bear weight on his right lower limb, sit crossed leg and squat since 1month

History of fever on and off since 1 month which is high grade not associated with chills and rigors,

no h/o diurnal variations, or no h/o periodicity
No h/o weight loss
...


Whats ur Dx??

Xray of the week‎ case: 1

5O Years old female patient presented with swelling around the posterior aspect of the right hand since 1 year. The swelling followed by the discharge since 5 months and the pain on and off around the wound and also the dark discoloration of the surrounding skin. The discharge is serous type with no any blood, pus or any smell. There is no history of any specules,bony fragments,granules in discharge.

   No history of any trauma, any wound over that area before. No history of any other bony swellings.

No history of any joint pains or joint stiffness. No history of any constitutional symptoms.

No history of any massages or other treatment other than analgesics.

EXAMINATION:

     Swelling around 5/5cms on dorso lateral aspect of right hand,with ulcer of 2/3cms ovoid shape with granulationtissue.

     No any active discharge, sclerosed margins with hyper pigmented surroundings.

     Base of ulcer is the 5^th metacarpal and floor by the dorsal interossei muscles.

     Deep bony tendernss present.

     No distal neurovascular deficit.

Investigations:

   CBP: Hypochromic normocytic anemia.DLC-normal

   ESR: 60 mm 1^st hr.

   Monteux: positive

   Biochemical investigations:  within normal limits.

Whats Your diagnosis??