Question 1099
{"accessible":true,"alternatives":[{"id":5490,"text":"Ewing sarcoma"},{"id":5491,"text":"giant cell tumor of bone"},{"id":5492,"text":"Langerhans cell histiocytosis"},{"id":5493,"text":"osteomyelitis"}],"archived":false,"correctAlternativeId":5493,"explanation":"\u003cp\u003eThere is an aggressive lytic process centered on the metaphysis with cortical destruction and periosteal reaction. The most likely diagnosis is osteomyelitis and any supportive clinical features of sepsis\u0026nbsp;should be sought. \u003ca href=\"/articles/langerhans-cell-histiocytosis\" title=\"Langerhans cell histiocytosis\"\u003eLangerhans cell histiocytosis\u003c/a\u003e (eosinophilic granuloma) could produce this appearance and is certainly a good differential diagnosis if the patient is not septic. Likewise, \u003ca href=\"/articles/ewing-sarcoma\" title=\"Ewing sarcoma\"\u003eEwing sarcoma\u003c/a\u003e could produce this appearance in a patient this age and would be another differential to consider, although the metaphyseal location would be unusual. \u003ca href=\"/articles/giant-cell-tumour-of-bone\" title=\"Giant cell tumour of bone\"\u003eGiant cell tumor of bone\u003c/a\u003e would not be in the differential as this occurs exclusively after the growth plate is closed and is typically subarticular in location with non-aggressive features.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eFrom:\u003c/strong\u003e\u0026nbsp;\u003ca href=\"https://radiopaedia.org/courses/radiology-review-course-online\"\u003eRadiology Review Course - Online\u003c/a\u003e\u003c/p\u003e","id":1099,"imageUrl":"https://prod-images-static.radiopaedia.org/multiple_choice_questions/692/osteomyelitis-distal-radius_big_gallery.jpeg","imageAttribution":{"kind":"case","rID":7526},"imageAttributionCaseInfo":{"title":"Osteomyelitis - distal radius","contributor_name":"Frank Gaillard","contributor_param":"frank","case_rid":7526,"case_param":"osteomyelitis-distal-radius"},"firstQuestionPath":"/questions/2578","nextQuestionPath":null,"relatedArticles":[{"id":1565,"title":"Langerhans cell histiocytosis","link":"/articles/langerhans-cell-histiocytosis?lang=us"},{"id":7662,"title":"Osteomyelitis","link":"/articles/osteomyelitis?lang=us"},{"id":1385,"title":"Giant cell tumor of bone","link":"/articles/giant-cell-tumour-of-bone?lang=us"},{"id":8478,"title":"Langerhans cell histiocytosis (skeletal manifestations)","link":"/articles/langerhans-cell-histiocytosis-skeletal-manifestations-1?lang=us"}],"alsoUsedIn":[{"id":167,"kind":"Course","title":"A to Z of Paediatric Radiology","link":"https://radiopaedia.org/courses/a-to-z-of-paediatric-radiology"},{"id":234,"kind":"Course","title":"Radiology Review Course - Melbourne - page 234","link":"https://radiopaedia.org/courses/radiology-review-course-melbourne-2019/pages/234"},{"id":234,"kind":"Course","title":"Radiology Review Course - Melbourne - page 234","link":"https://radiopaedia.org/courses/radiology-review-course-melbourne-2018/pages/234"},{"id":234,"kind":"Course","title":"Radiology Review Course - Melbourne - page 234","link":"https://radiopaedia.org/courses/radiology-review-course-melbourne-2020/pages/234"},{"id":234,"kind":"Course","title":"Radiology Review Course - page 234","link":"https://radiopaedia.org/courses/radiology-review-course-online/pages/234"}],"stem":"\u003cp\u003e12-year-old with wrist pain. What is the most likely diagnosis?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/1099"}],"attemptsPercentages":[{"alternativeId":"5493","percentage":57},{"alternativeId":"5492","percentage":21},{"alternativeId":"5491","percentage":6},{"alternativeId":"5490","percentage":17}],"promptToLogin":false,"questionManager":false,"articleId":"ewing-sarcoma"}