Date : 00.00.00

Name of the Patient : Abc Xyzootwlmn / M / 14 yrs.
Referred by : Dr. Abc Xyz. Kapadia.
Examination : M.R.I. of the Left Distal Femur.

CLINICAL PROFILE :

C/O pain above the left knee joint since 1 month.
H/O being hit by a season ball 1 year back.

EXAMINATION :

M.R.I of the left distal femur was performed using the following parameters :

5 mm thick T1 Weighted, proton and GRASS sagittal images.
5 mm thick T1 Weighted and STIR coronal images.
6 mm thick T1 Weighted axial images.

OBSERVATION :

There is a large well-defined mass lesion in the lower one third of the left femur which extends cranially for about 14.5 cms from the left knee joint. There is a clear zone of transition between the lesion and normal marrow. Mixed signal intensity areas are seen in this lesion on the T1 Weighted images which are seen to turn heterogeneously hyperintense on the proton, GRASS and STIR images. There is break in the anterior and posterior cortex with periosteal elevation and spread of the pathology in the adjacent soft tissue. The lesion is predominantly metaphyseal. The epiphysis shows a mottled appearance in the medial and lateral condyle and is hypointense on the T1 Weighted images and turns hyperintense on the proton, STIR and GRASS images suggestive of its involvement.

The left knee joint however appears to be spared.

Effusion is noted within the left knee joint.

The femoral attachment of the anterior and posterior cruciate ligament of the femur is also involved.

IMPRESSION :

The MRI features are suggestive of a mass lesion in the distal metaphysis of the left femur
with its cranio-caudate extension measuring 14.5 cms with involvement of the epiphysis and periosteal extensions as described. This most probably represents an osteogenic sarcoma.