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This document summarizes 8 medical cases: 1) A young man with knee pain and fever who develops draining sinuses, consistent with chronic osteomyelitis. 2) A debilitated man with back pain, fever, and spinal deformities, showing granulomas on bone section, consistent with tuberculosis. 3) An obese woman with joint pain and difficulty walking, showing cartilage erosion and cysts consistent with osteoarthritis. 4) A woman with morning joint stiffness, showing rheumatoid arthritis on femoral head section. 5) A teenage boy with a leg swelling and pain, showing an osteochondroma on section. 6) A teenage girl with thigh pain and swelling plus weight loss.
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- 2. CASE 1
- 3. A 22 years old male presented with localized pain above his right knee joint with recurrent fever. Later, he had a discharging sinuses from the skin overlying the right knee. What is the most likely diagnosis ?
- 5. This is chronic osteomyelitis. Note the fibrosis of the marrow space accompanied by chronic inflammatory cells. There can be bone destruction with remodelling. Osteomyelitis is very difficult to treat.
- 6. CASE 2
- 7. • A 35 years old debilitated man presented to the orthopedic clinic with back pain, low grade fever, marked elevation of sedimentation rate and recent kyphosis and scoliosis . • The patient has a history of coughing up blood, fever, chills, night sweats, weight loss, pallor, and often a tendency to fatigue very easily.
- 9. Section of bone shows granuloma formation with epithelioid like cells , langhans-type giant cells and rim of lymphocytes
- 10. CASE 3
- 11. • An obese 56 years old woman presented with bilateral localized pain to her knees, hands and difficulty in walking .
- 13. Progressive erosion of articular cartilage, eburnated articular surface , subchondral cyst and residual articular cartilage (Osteoarthritis
- 14. Mushroom-shaped osteophytes (bony outgrowths ) develop at the margins of the articular surface and are capped by fibrocartilage and hyaline cartilage that gradually ossify . Note the absence of inflammation . (Osteoarthritis)
- 15. CASE 4
- 16. • A 40 years old woman complains of malaise and stiffness in her joints each morning .
- 17. • Rheumatoid arthritis affecting the head of femur. The synovium becomes edematous, thickened and hyperplastic and transforming its smooth contour to one covered by delicate and bulbous fronds
- 19. CASE 5
- 20. • A 16 years old male was found to have a small swelling protruding from upper part of his leg with local pain .
- 21. This is an osteochondroma of bone. This benign lesion appears as a bony projection (exostosis). Most are solitary, incidental lesions that may be excised if they cause local pain. There is a rare condition of multiple osteochondromatosis marked by bone deformity and by a greater propensity for development of chondrosarcoma.
- 23. CASE 6
- 24. An 18 years old female presented to the rheumatology clinic with 2 months history of pain and swelling in her upper thigh with weight loss
- 27. CASE 7
- 28. This picture shows a histopathological section taken from a mass which was found in the upper thigh of a 36 years old male .
- 30. A) What is the pathological diagnosis ? B) Describe the histopathological features seen . C) Name the malignant mesenchymal soft tissue tumours that arise from : 1- striated muscle . 2- bone .
- 31. CASE 8
- 32. This rapidly growing thigh mass in a 55 years old man with the shown findings is most likely to be