PMC5567474_01
X-Ray radiographs showing severe osteomalacia and multiple fractures. a Right radial head and right ulnar shaft fracture; b Left mid ulnar shaft fracture; c Right humerus anatomical neck fracture and Distal clavicular resorption
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Fig1
Radiography studies showed osteomalacia, looser zones, and multiple fractures in ribs, neck of the humerus of both sides, both ulnas, the right radius, the proximal femur of both sides, and the left first metacarpal bone (Figs. 1 and 2a).
T1 weighted MRI: a Femoral neck and subtrochanteric fractures on both sides (arrow heads), and bilateral coxa vara deformities; b A mass-like lesion in medial aspect of the left distal femur metaphysis (arrow)
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Fig2
Radiography studies showed osteomalacia, looser zones, and multiple fractures in ribs, neck of the humerus of both sides, both ulnas, the right radius, the proximal femur of both sides, and the left first metacarpal bone (Figs. 1 and 2a). To localize the tumor, a whole body MRI was performed, which revealed a mass-like lesion in the proximal metaphysis of the left tibia and the distal metaphysis of the left femur (Fig. 2b).
18F-FDG PET: a hypermetabolic lesion in medial aspect of the left distal femur (arrow)
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Fig3
The 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) scan showed a hypermetabolic lesion (maximum standardized uptake value = 21.28) in the medial aspect of the left distal femur (Fig. 3).
Knee CT scan: a 28*26*24 mm lobulated lytic mass in posteromedial aspect of the left distal femoral metaphysis with cortical disruption and extra osseous soft tissue formation (arrow)
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Fig4
The Knee CT scan revealed a 28*26*24 mm lobulated lytic mass in the posteromedial aspect of the left distal femoral metaphysis with a cortical disruption and an extra osseous soft tissue formation (Fig. 4).