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  #1  
Old 08-22-2011
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Default bone pain

A 25-year-old male who is an avid runner complains of leg pain, which is worse at night for the past month. Radiographs show a lesion in the diaphysis of the tibia. A biopsy is taken and shows a 1cm nidus of vascular osteoblastic tissue interlacing trabeculae of immature woven bone lined by regularly arranged osteoblasts. This nidus is surrounded by normal reactive bone. What is the next step in treatment?
A. Treat with salicylcates
B. Obtain an MRI
C. Treat with radiation therapy
D. Reassurance
E. Treat with chemotherapy
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  #2  
Old 08-22-2011
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Default option B

its osteoid osteoma , i think.. obtain mri . to identify d extend f tumor. n do surgery...
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  #3  
Old 08-22-2011
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Default A

A, treat with NSAIDS. from eMedicine.com:

"Initial treatment of osteoid osteoma remains nonoperative, with medications consisting of aspirin or other NSAIDs"


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Originally Posted by ricko335 View Post
A 25-year-old male who is an avid runner complains of leg pain, which is worse at night for the past month. Radiographs show a lesion in the diaphysis of the tibia. A biopsy is taken and shows a 1cm nidus of vascular osteoblastic tissue interlacing trabeculae of immature woven bone lined by regularly arranged osteoblasts. This nidus is surrounded by normal reactive bone. What is the next step in treatment?
A. Treat with salicylcates
B. Obtain an MRI
C. Treat with radiation therapy
D. Reassurance
E. Treat with chemotherapy
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  #4  
Old 08-22-2011
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Default

obtain an MRI!
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  #5  
Old 08-22-2011
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this is not step 1! tumor is osteoid osteoma
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  #6  
Old 08-23-2011
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Default A.

Quote:
Originally Posted by ricko335 View Post
A 25-year-old male who is an avid runner complains of leg pain, which is worse at night for the past month. Radiographs show a lesion in the diaphysis of the tibia. A biopsy is taken and shows a 1cm nidus of vascular osteoblastic tissue interlacing trabeculae of immature woven bone lined by regularly arranged osteoblasts. This nidus is surrounded by normal reactive bone. What is the next step in treatment?
A. Treat with salicylcates
B. Obtain an MRI
C. Treat with radiation therapy
D. Reassurance
E. Treat with chemotherapy
A. Treat with salicylcates
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  #7  
Old 08-24-2011
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Default

The correct answer is A.
The patient in the question stem has a classic description for a benign osteoid osteoma. It is a self-limited benign bone lesion that produces pain in young patients (5-30 years of age). Histology will show a nidus of vascular osteoblastic tissue interlacing trabeculae of immature woven bone lined by regularly arranged osteoblasts. This nidus is surrounded by normal reactive bone.
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