Cirugía de Columna y Articulaciones: Discusión entre pares / Good afternoon my coleagues , I' d like to know what is this???????

Indian-Orthopaedic Research-Group

Hamed Wagdy Abdo

Good afternoon my coleagues , I' d like to know what is this??????? ,femal pt. aged 45 years with chronic lt leg pain with failed all medical ttt, with normal ex. So what is the management?

Professor-Abdelsalam Eid It is X rays like this that really make my day. Brain storming? What do you people think? I say that and I am already trying to find an answer.

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Professor-Abdelsalam Eid Long history. Any obvious deformity?

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Mohamed Ibrahim Elbaqary what about paget's disease

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Ashraf Yassin Paget is the only thing come to my mind

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Eslam Mohamed Mohamed Yes, i think it is paget's

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Mostafa Showman no any history of previous infection ?

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Mostafa Showman THERE IS TIBIO-FIBULAR SYNOSTOSIS + post baw of proximal tibia

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Mostafa Showman
يا بيه ايه الحل ماحدش عارف؟

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Eslam Mohamed Mohamed No cortical erosion, i think the bones had been reformed

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Mostafa Showman it may be post-infectious.

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Eslam Mohamed Mohamed Osteomyelitis u mean?

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Mostafa Showman yes post-osteomyelitis

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Mostafa Showman Do u agree with me ?

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Eslam Mohamed Mohamed I,m afraid , not really.

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Eslam Mohamed Mohamed Because no history of trauma"predisposing factors" no history of acute symptoms of osteomyelitis.

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Eslam Mohamed Mohamed ?

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Mostafa Showman there is tibio -fibular synostosis ; post. baw of proximal tibia ; areas of periosteal reaction , new bone formation and others of osteonecrosis . so what?

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Eslam Mohamed Mohamed Also a possibility

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Professor-Abdelsalam Eid I also thought Paget's. A full length leg X ray would be more helpful and more history.

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Mostafa Showman thanks professor , i think the guys took the right path.

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Ayman Mostafa I think it is metabolic or vascular problem but pagets was the first diagnosis knocking my mind

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Mohamed Soliman Kotb Paget's disease

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Mohamed Soliman Kotb Plz do alp,ask about visual,cardiac and neurological symptoms

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Mohamed Soliman Kotb Remember steel syd.

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Haytham Agwa Serum alkaline phosphatase and 24 hours. Hydroxyproline

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Eslam Mohamed Mohamed If so, wt is the management?

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Mohamed Abulsoud other musclosceletal complaint. spine . pelvis. hands and skull x ray plus lab

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د.عبدالمجيد أبوالعباس أبوالبراء Follow

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Tamer Kadry Madawy I think you should firest see x ray for the other side to compair....and full history

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Eslam Mohamed Mohamed If free, does it mean anything?

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Eslam Mohamed Mohamed Dr Tamer Kadry Madawy