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Postgraduate Medical Journal 2004;80:740
© 2004 Fellowship of Postgraduate Medicine

SELF ASSESSMENT QUESTION

Fracture in pregnancy

Pathological fracture in a pregnant woman

P Chaturvedi , A Puri , M G Agarwal , P S Pai , K A Pathak , D A Chaukar , M S Deshpande , A K Decruz

Department of Surgery, Tata Memorial Hospital, Mumbai, India

Correspondence to:
Correspondence to:
Dr Pankaj Chaturvedi
Assistant Professor, Tata Memorial Hospital, EB Road, Parel, Mumbai 400 012; pankajch37@yahoo.com

Submitted 15 November 2003
Accepted 15 January 2004

Answers on p 743.

The first 100% of the full text of this article appears below.

A 27 year old woman presented in the third trimester of pregnancy with a history of gradually progressive pain in the upper end of her humerus. There was no significant medical history or any other associated illness. Magnetic resonance imaging (MRI) revealed a pathological fracture with extensive marrow replacement of the upper humerus and an associated large soft tissue mass in the upper arm (fig 1Go). A core needle biopsy documented benign giant cells. The patient was treated with excision and replacement with a prosthesis.


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  		Figure 1  MRI showing a lytic lesion with pathological fracture and soft tissue extension in the upper end of the humerus.

 

QUESTIONS
  1. What is the differential diagnosis based on the history and the MRI (giant cell tumour, brown tumour, chondrosarcoma, secondaries in the bone)?
  2. What other relevant blood investigation should be ordered in such patients (calcium, parathyroid hormone, alkaline phosphatase, acid phosphatase)?


Relevant Article

Pathological fracture in a pregnant woman
Postgrad. Med. J. 2004 80: 743. [Extract] [Full Text] [PDF]





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