A female patient under treatment for acute leukemia complaints of bilateral knee pain.
OA both b/l knee w reducing joint space in medial compartment. But other reasons may be Leukemia or myelodysplastic syndromes (MDS)can cause bone or joint pain, usually because bone marrow has become overcrowded with cancer cells.check S.uric acid inflammatory markers etc
Spiking of tibial spines. No other bony abnormality detected.
i feel there is a little patchy softening seen in the femur in the centre seen only in lateral view..
Spiking of tibial spine with narrowing of joint space on both sides suggests OA
Minimal narrowing of both joint spaces noted with prominent intercondylar eminences in both tibia suggests O.A.changes,Otherwise no other bony lesion noted
There is osteolytic lesion over lower end of the femur and the patient on chemo so most likely osteosarcoma,diaphysis involvement may be the cause of pain.
This it pain may be due to hyperuricemia caused both by disease itself or due to chemotherapy induced , pain also may be due to expansile lesion of bone marrow which is caused by leaukemic over crowding of marrow cells or blast crisis, in this pt peripheral smear should be examined to see the blast count if increases treatment modality may be changed this pt should be kept uric acid level normal by allopurinol or febuxostat ,or uricase according to level of uric acid or control status
OA bilateral knee joint
Osteolytic Lesions in llo2er third of femurs
Hello dr. Leukemia is a virus present in ur blood.without clearing the virus how can u make the system to work normally to improve the immune.it may affect the bones too.without clearing the virus u cant remove the pain in the joint.
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