Zhang Yao, Department of Orthopedic Surgery, Zhongshan Hospital, Dalian University, China: From the bone scan results, the bone metabolism is active, and combined with the MRI results, the bone destruction has reached the joint surface, so early surgery is recommended. There is sclerosis at the edge of the lesion and no destruction of the bone cortex considered as benign bone tumor or tired tumor-like lesion. Zhang Yao, Department of Orthopedic Surgery, Zhongshan Hospital, Dalian University, China: Description of the condition (onset time, main symptoms, hospital visited, etc.): Hello doctor, I would like to ask you about the MR diagnostic report as follows: a type of round abnormal signal is seen in the upper end of the left tibia, with a size of about 5.8CM*4.5CM*3.4CM; the margins are clear, the lesion is multi-room cystic change, the main body is watery signal, and mixed signal shadow is seen within it ( T1W1 slightly high signal, T2W2 slightly low signal), after enhancement, part of the edge of the ring reinforcement, the upper boundary of the lesion reaches the joint surface, there is no mass in the adjacent soft tissue; left knee joint medial and lateral meniscus, anterior and posterior cruciate ligaments. The morphology and signal of the medial and lateral collateral ligaments were not abnormal, and the remaining left knee component bones were not abnormal. The medial vein of the left calf is thickened and distorted; we are advised on the treatment and the cost of the consultation: Hello! Because we can’t see the film, only from the diagnostic MRI report you provided, the possibility of giant cell tumor of the left tibia bone is very high, and the watery signal within it may be tumor necrosis and bleeding, but the possibility of aneurysmal bone cyst, or a giant cell tumor of bone combined with aneurysmal bone cyst cannot be excluded, and attention should be paid to differentiation. Aneurysmal bone cyst is a benign tumor-like lesion, while giant cell tumor of bone is also considered as benign tumor which is prone to recurrence. Both of them can be surgically scraped, but special attention should be paid to the thoroughness of resection, and the residual cavity after scraping can be filled with bone graft or bone cement. From the report you provided, the tumor is relatively large and close to the joint, so internal fixation such as titanium plate is needed after scraping and filling. Patient: 1. Thank you for your reply, thank you very much! Now I am adding the bone scan results to see if we can wait for further clarification! 2, today went to do the ECT whole-body bone imaging scan scan results are as follows: examination seen: tracer: 99mTc-MDP; dose 20mCi. Intravenous injection of tracer, 3 hours after the whole body anterior-posterior position at the same time phenomenon (high-resolution scan array, 15cm/min). The whole-body skeleton was clearly visualized, and the background of Ruan’s tissue was not high. A limited foci of abnormal tracer concentration were seen on the medial side of the left upper tibia, and the rest of the tracer distribution was symmetrical from left to right. Impression Abnormal foci of concentration in the medial aspect of the left upper tibia, suggesting active bone metabolism and suggesting further examination.
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