The clues in the question here is unilateral pain which is waking her at night. Osteosarcoma also has a peak incidence of 12-14 years. Ewings sarcoma is also a differential diagnosis. Over 90% of osteosarcomas occur in the metaphysis and around 80% occur in bones around the knee (distal femur, proximal tibia or fibula). Ewings sarcoma have a tendency to occur in the diaphysis (midshaft) and commonly occur in the pelvis. This is not Osgood-Schlatter disease, an apophysitis of the tibial tuberosity, as it is usually bilateral and worse after strenuous exercise.
Posted on: Tue, 22 Jul 2014 20:32:25 +0000