Submitted by Peyman Kangavari, MD and Thomas Learch, MD.
History of Present Illness
7-year-old female presented to the orthopedic surgeon's office complaining of 3 weeks of right arm pain, which began after patient was hit with a handball. Initial radiographs of the right arm were obtained in the office, which demonstrated a lytic lesion in the right humeral diaphysis.
Fontal and lateral radiographs of the right arm demonstrate a lytic lesion in the mid-distal right humeral diaphysis, with adjacent non-aggressive appearing periosteal reaction. No fracture or other lesion is seen.
What’s the next step in management?