A teenage girl presented to the outpatient clinic with a one year history of persistent, progressive pain and swelling in her right lower leg. The swelling was exacerbated by walking, did not improve with rest, and was affecting her daily life. She had no history of recent trauma or fever. On clinical examination, compared with the left leg, the right lower leg was warm, accompanied by strong pulsation on palpation on the lesion area. The patient’s C reactive protein, alkaline phosphatase, and white cell count were normal. A plain radiograph of the right leg was requested (fig 1).bmj;383/nov16_6/e076551/F1F1f1Fig 1Radiograph of the right fibulaQuestionsWhat does the radiograph show?What are the differential diagnoses?What further investigations are required?Answers1.What does the radiograph show?The radiograph (fig 1) shows an expansive bony lesion in the middle and upper part of the right fibula. Changes included disappearance of the trabecular bone, marrow cavity expansion, and local cortical…
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