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Virtual case of the month
Rare and unusual bone dysplasia
  1. Yazhuo Li,
  2. Lili Hu,
  3. Hongwei Wang,
  4. Yiduo Jin,
  5. Xuan Zang
  1. Department of Pathology, The Fourth Medical Center of The PLA General Hospital, Beijing, China
  1. Correspondence to Dr Hongwei Wang; whw6626@sina.com

https://doi.org/10.1136/jclinpath-2019-206101

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    Clinical question

    A 47-year-old man presented with a history of pain in the left lower extremity and a five-year history of limitation of movement. After activity, the symptoms became worse and clinical images showed multiple lesions of the left tibia and fibula. For the last 5 years, the patient had experienced aggravation of symptoms and limitation of hip and knee joint motion (figure 1A). A removal of hyperplastic bone was performed from the left hip and knee joints. Review the high-quality, interactive digital Aperio slide at http://virtualacp.com/JCPCases/jclinpath-2019-206101/ and consider your diagnosis.

    Figure 1

    (A) The clinical image: the examination revealed that the left lower extremity was slightly swollen, and the skin colour of the left thigh and the left knee joint became darker, without obvious congestion, ecchymosis and venous engorgement. The multiple nodules could be touched in the left lateral thigh, which were hard and inactive. The mobility of the left knee joint was 30–90°C, and the one of the left hip joint was 10–50°C. (B) X-ray: the preoperative computed tomography images of the hip joint. The left ilium and femur were widely hyperostosis and sclerosis, forming masses in a roughly rounded or strip shape. High density shadows can be seen …

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    Footnotes

    • Handling editor Iskander Chaudhry.

    • Correction notice This article has been corrected since it was published Online First. The slide link has been updated.

    • Contributors YJ and XZ performed the experiments. YL and LH provided essential material. YL and HW designed the experiments. YL wrote the draft of the manuscript. YL and HW critically reviewed the manuscript. All authors approved the final version of the manuscript.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Commissioned; internally peer reviewed.