Case Challenge

Hip & Thigh

Stephen J Pomeranz

Gain confidence interpreting Hip MRI with practice cases from MRI Online. Quiz yourself using real-world DICOMs & earn CME. Try it free!

Case Review

Musculoskeletal (MSK)

Post-Course Activities

This Power Pack is comprised of 25 unique Hip MRI cases that you can scroll through in our diagnostic web viewer to determine your findings. Quiz yourself and earn CME.

Hip MRI Cases

Case 1 - 20-year-old male has left hip pain when bearing weight

<div>HISTORY:&#160;This 20-year-old male has left hip pain when bearing weight and pushing hip out anteriorly.UNLIKELY DIFFERENTIAL DIAGNOSIS: Lymphoma / Hodgkin&#8217;s diseaseDIAGNOSIS: PendingUsing the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS:&#160;A large expansile mass of indeterminate character is 6.3cm long and 4cm in transverse dimension in a 20-year-old young male.&#160;Epimetaphyseal involvement all the way to the bone end is identified.&#160;Differential diagnosis includes the family of bone end lesions including giant cell tumor, chondroblastoma with or without clear cell chondrosarcomatous degeneration, telangiectatic osteogenic sarcoma (rare); however, in this position within the femur, the family of lymphoproliferative disorders is unlikely.&#160;Furthermore, the pattern of involvement is inconsistent with eosinophilic granuloma.&#160;The findings are definitively neoplastic in nature.&#160;Surrounding areas of osteoedema extend into the trochanteric crest.&#160;&#160;&#160;Scant reactive effusion.&#160;&#160;&#160;Lesion is solitary.&#160;&#160;Lesion is expansile.&#160;&#160;Tissue sampling will be necessary along with clinical history taking exclusion of any other potential sites of involvement although unlikely.&#160;&#160;Incidentally noted left hydrocele.&#160;Conventional radiograph is requested for further lesion characterization and matrix analysis.&#160;&#160;CONCLUSION:&#160;&#160;&#160;Expansile mass involving predominantly the epimetaphysis and epiphysis all the way to the bone end, of indeterminate aggression.&#160;Differential diagnosis given in the body of the report but first step is request for conventional radiograph and correlation of such.</div>

Case

Which of the following would be an UNLIKELY choice for a differential diagnosis in this case?