Discusión entre pares / 2 year old boy with one month history of progressively increasing swelling of Rt shoulder....

Indian-Orthopaedic Research-Group

Abilash Mt

19 de abril a la(s) 5:39

2 year old boy with one month history of progressively increasing swelling of Rt shoulder.Initially painful now pain decreased.No hlstory of fall.plz comment on differential diagnosis...

• 

  Viswanath Chavali Osteomyelitis with septic arthritis

  19 de abril a la(s) 5:42 · Editado · Me gusta · 1
• 

  Ahmed Nafady CT Rt shoulder

  19 de abril a la(s) 5:53 · Editado · Me gusta
• 

  Ahmed Nafady Osteosarcoma ??

  19 de abril a la(s) 5:55 · Me gusta
• 

  AL Khateeb Osteosarcoma,?Ewing sarcoma,?osteomyelitis ?need good history,lab.test ,MRI and biopsy

  19 de abril a la(s) 6:00 · Me gusta · 3
• 

  عبد المنعم جمعه ? Fever..cbc..esr..crp...mri

  19 de abril a la(s) 6:00 · Me gusta
• 

  Zar Ni Nyo Win My provisional diagnosis is osteomyelitis with septic arthritis. Differential diagnosis is Malignancy...Osteosarcoma

  19 de abril a la(s) 6:04 · Me gusta · 4
• 

  Golam Mahmud Suhash Ewing sarcoma may be

  19 de abril a la(s) 6:06 · Me gusta
• 

  Mahmood Gohar This is a metaphyseal lesion with erosion of physis & epiphysis and periosteal reaction .. in young age .. could be Osteomylitis . Septic arthritis or osteosarcoma . For lab investigations .. CBC ESR CRP ALK.PH MRI..

  19 de abril a la(s) 6:08 · Me gusta · 1
• 

  Sandeep Wasnik Osteomyelitis with septic arthritis

  19 de abril a la(s) 6:28 · Me gusta · 1
• 

  Pravin Siddharth Invetgtn reports???

  19 de abril a la(s) 6:37 · Me gusta
• 

  Amr Yasser Hassan Osteomyelitis v osteosarcoma for investigation

  19 de abril a la(s) 6:52 · Me gusta
• 

  Pravin Kanabar Pyogenic arthritis of shoulder with Osteomyelitis of humerus

  19 de abril a la(s) 7:02 · Me gusta
• 

  Sanjay Joseph Most likely osteomyelitis. Must rule out malignant tumour.

  19 de abril a la(s) 7:26 · Me gusta
• 

  Kurian Alappatt Gorhams disease massive osteolysis

  19 de abril a la(s) 7:26 · Me gusta
• 

  Abdullah Alswedan Osteomyelitis And septic arthritis

  19 de abril a la(s) 7:40 · Me gusta
• 

  Jayesh Shah Most likely osteosarcoma. Scapula glenoid is normal. Significant new bone from periosteum

  19 de abril a la(s) 8:18 · Me gusta
• 

  Jayesh Shah Mri to see margins from neural and vascular structures. Biopsy. Blood investigations and see if you can salvage the limb or else for quarter amputation followed by chemotherapy

  19 de abril a la(s) 8:20 · Me gusta
• 

  Sunil Kumar Gorrams

  19 de abril a la(s) 8:41 · Me gusta
• 

  Phyo Mg Mg for 2 yr, osteosac is unlikely. the most possible is infection.

  19 de abril a la(s) 8:44 · Me gusta
• 

  Phyo Mg Mg moreover, if look the X ray features thoroughly, it cannot be malignancy.

  19 de abril a la(s) 8:46 · Me gusta
• 

  Javed Shaikh Ewings/infection

  19 de abril a la(s) 9:09 · Me gusta
• 

  Ahmed Nafady Why it can't be malignancy !?

  19 de abril a la(s) 9:53 · Me gusta
• 

  Abdullrab Almarwanya Thank you for presenting this case: starting from the reversely posted x-ray of the right upper humerus and shoulder region there is evidence of huge, circular, soft tissue shadow distending the shoulder joint causing the humerus to deviate laterally and inferiorly ,erosive bony resorption and destruction of the medial cortex (cyst formation , reduced metaphyseal bone density)( late x ray changes in OM?? date of x ray??), some bony sclerosis laterally. Taking the patient age,course and the presentation in consideration the diff. could include :Osteomyelitis,Septic arthritis , Osteofibrous dysplasia ,Metastatic rhabdomyosarcoma ,Metastatic neuroblastoma ,Leukemia For working on this differential i would suggest : EXAMINATION: General: condition for evidence of toxic appearance , fever, feeding , taking body weight(??kg). Local :five cardinal sign of inflammation(-\+ve). INVEST.: CBC(WBC) ,ESR , CRP ,Plasma procalcitonin ,Blood culture ,Joint aspiration should include cell count with differential ,Gram stain, culture, and sensitivities ,glucose , protein level and histopathology .Bone scan ,Bone Marrow aspiration as indicated. IMAGE: CXR ,soft tissue U\S for the shoulder , if not helpful one can decide for CT,MRI. THANKS

  19 de abril a la(s) 10:50 · Editado · Me gusta · 8
• 

  Paudel Sushil Ewings...MRI n then Biopsy

  20 de abril a la(s) 11:16 · Me gusta