A 20-year-old man presents to the clinic complaining of discomfort over the lateral aspect of his right knee. The physician notices a palpable ‘bump’ in this region on physical examination. A radiograph of the knee reveals a lateral bony projection from the lower femoral metaphysis. There is no adjacent soft tissue swelling. The excised lesion […]


A patient presents with a history of systemic lupus erythematosus with renal complications. The ongoing medication includes long-term corticosteroid therapy. Which of the following bone diseases is most likely to develop in this patient?


A 6-year-old boy measures at the 5th percentile in height for age. Upon physical examination, it was found that most of his decreased height was due to very short legs. However, his trunk and head appear normally proportioned for his age. He is of above-average intelligence and becomes a doctor. His parents and relatives are […]

Gout- Chronic renal failure

A 52-year-old man presents to the physician complaining of a slowly enlarging ‘bump’ on his left elbow for the past 2 years. Upon physical examination, there is a 2 cm firm, non-tender mass over the left olecranon process. An aspirate from this mass examined microscopically shows elongated, negatively birefringent, needle-shaped crystals under polarized light. The […]

Serum prostate specific antigen of 35 ng/mL

A 66-year-old man complains of persistent dull back pain for 4 months, unrelated to physical activity. He has noted a 7 kg weight loss during this time. On physical examination, there are no remarkable findings. A CT scan of the spine reveals scattered bright lesions of 0.5 to 1.5 cm in the vertebral bodies. Laboratory […]

Aneurysmal bone cyst

A 20-year-old woman presents with pain and swelling of her right distal thigh associated with activity for the past year. She has no history of any trauma. On examination, there is tenderness on palpation above the right knee after performing physical exercise. Radiographs show an expansile, eccentric, lytic lesion in the distal femur metaphysis surrounded […]

Paget disease of bone

A 65-year-old man presents with increasing back and leg pain for 2 years. He also reports difficulty hearing in the left ear. A decreased range of motion at the hips is noted upon physical examination. The patient also reports that his hats do not even fit him anymore. He now has orthopnea and pedal edema. […]