Make the Diagnosis: A Man with Wrist Pain for Three Months

(MedPage Today) -- Case Study: A thirty-three-year-old man presented to a Tennessee orthopaedic clinic with a three-month history of pain in the left wrist. He reported no recent trauma to the extremity, no respiratory illness preceding the wrist pain, and no fever, chills, or other constitutional symptoms. Physical examination of the left wrist revealed tenderness over the distal part of the radius but no palpable masses or overlying skin changes. The patient had full range of wrist motion and was neurologically intact. Radiographs of the wrist, shown here, demonstrated a radiolucent lesion in the lateral aspect of the distal radial epiphysis, with sharp borders and mild cortical thinning. Open biopsy revealed a lesion composed of soft, reddish-brown tissue. The intraoperative frozen section revealed multinucleated giant cells with monotonous mononuclear stromal cells. The lesion was removed; the cavity was then treated with a power burr and argon beam coagulator and filled with gentamicin-impregnated polymethylmethacrylate bone cement.
Source: MedPage Today Dermatology - Category: Dermatology Source Type: news