TUTORIAS MUSCULOSKELETAL SYSTEM

2. CASE 1

3. A 22 years old male presented with localized pain above his right
knee joint with recurrent fever. Later, he had a discharging sinuses
from the skin overlying the right knee. What is the most likely
diagnosis ?

5. This is chronic osteomyelitis. Note the fibrosis of the marrow space
accompanied by chronic inflammatory cells. There can be bone
destruction with remodelling. Osteomyelitis is very difficult to treat.

6. CASE 2

7. • A 35 years old debilitated man presented to the orthopedic clinic with
back pain, low grade fever, marked elevation of sedimentation rate
and recent kyphosis and scoliosis .
• The patient has a history of coughing up blood, fever, chills, night
sweats, weight loss, pallor, and often a tendency to fatigue very easily.

9. Section of bone shows granuloma formation with epithelioid
like cells , langhans-type giant cells and rim of lymphocytes

10. CASE 3

11. • An obese 56 years old woman presented with bilateral localized pain
to her knees, hands and difficulty in walking .

13. Progressive erosion of articular cartilage,
eburnated articular surface , subchondral cyst and
residual articular cartilage
(Osteoarthritis

14. Mushroom-shaped osteophytes (bony outgrowths ) develop at the margins of the
articular surface and are capped by fibrocartilage and hyaline cartilage that
gradually ossify . Note the absence of inflammation .
(Osteoarthritis)

15. CASE 4

16. • A 40 years old woman complains of malaise and stiffness in her joints
each morning .

17. • Rheumatoid arthritis affecting
the head of femur. The
synovium becomes
edematous, thickened and
hyperplastic and transforming
its smooth contour to one
covered by delicate and
bulbous fronds

19. CASE 5

20. • A 16 years old male was found to have a small swelling protruding
from upper part of his leg with local pain .

21. This is an osteochondroma of bone. This benign lesion appears as a bony projection
(exostosis). Most are solitary, incidental lesions that may be excised if they cause
local pain. There is a rare condition of multiple osteochondromatosis marked by
bone deformity and by a greater propensity for development of chondrosarcoma.

23. CASE 6

24. An 18 years old female presented to the rheumatology
clinic with 2 months history of pain and swelling in her
upper thigh with weight loss

27. CASE 7

28. This picture shows a histopathological section taken
from a mass which was found in the upper thigh of a 36
years old male .

30. A) What is the pathological diagnosis ?
B) Describe the histopathological features seen .
C) Name the malignant mesenchymal soft tissue tumours that arise from
:
1- striated muscle .
2- bone .

31. CASE 8

32. This rapidly growing thigh mass in a 55 years old man with the
shown findings is most likely to be