With a physical examination this athlete showed no fever and his vital signs where stable. But, he had significant pain with movement of the left knee. Obviously, a 13-year-old boy may not provide all the necessary information. But the doctor assumed the boy might have some kind of twisting injury while playing football, in addition to the direct blow. There are many different conclusions one could follow. The patient may have a lateral collateral ligament strain or tear. One important point to remember is that in young people the ligament is sometimes stronger than the bone, and the injury may be a physeal plate fracture than a tear.
An MRI scan can be helpful in making a diagnosis of cruciate ligament tear. The injury may be a PCL tear with an ACL tear or in isolation. Given the history and physical examination, The doctor obtained x-rays, including anteroposterior, lateral, and oblique views, and an MRI scan to rule out a meniscus, ACL, or PCL tear.
TEST RESULTS:
CAT scan of the knee revealed a permeative lesion of the posterolateral aspect of the distal femur extending into the soft tissue and raising the cortex lightly. And a bone scan was normal. Diagnosis includes a malignant tumor. With taking into mind the patients age, history physical exam and X-rays, by far the most likely malignant tumor would be an osteogenic sarcoma. The patient went through incisional biopsy of him femoral mass relieved an osteogenic sarcoma. Three weeks after the patients biopsy, Hickman catheter was inserted, and preoperative chemotherapy was begun. About 6 weeks after therapy the patients left leg was amputated above the knee. This was the only way he was able to survive this ordeal, even though he was not able to play football again.