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(A) Swelling of the knee and pain were the presenting complaints of this 12-year-old adolescent girl who was seen twice in the ED and sent home without.

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Presentation on theme: "(A) Swelling of the knee and pain were the presenting complaints of this 12-year-old adolescent girl who was seen twice in the ED and sent home without."— Presentation transcript:

1 (A) Swelling of the knee and pain were the presenting complaints of this 12-year-old adolescent girl who was seen twice in the ED and sent home without any radiographic studies. (B) Frontal view of the knee shows area of sclerosis in the metaphysis of the distal femur with a Codman triangle (arrow). Findings are consistent with osteosarcoma. The presence of sclerosis and the lack of a permeative appearance (moth-eaten) distinguishes this lesion from Ewing sarcoma. (C) Sagittal computed tomographic scan of the same knee show marked area of sclerosis in the distal metaphysis, a Codman triangle, and soft tissue density surrounding the distal femur. (D) Axial T1 MR image of the knee demonstrates bone marrow invasion (white arrow) by tumor surrounded by soft tissue tumor (black arrow). (Photo contributors: Silvia Delgado-Villalta, MD. [A] and John Amodio [B–D].) Source: Chapter 11. Hematology and Oncology, Atlas of Pediatric Emergency Medicine, 2e Citation: Shah BR, Lucchesi M, Amodio J, Silverberg M. Atlas of Pediatric Emergency Medicine, 2e; 2013 Available at: Accessed: October 16, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved

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