Keywords
Athletic Trainers in Physician Practice Society Meeting and Conference 2025
Abstract
Background: Musculoskeletal tumors are relatively rare, accounting for only 0.2 to 0.5% of all malignancies across all age groups. More specifically, Pigmented Villonodular Synovitis, a type of musculoskeletal tumor, has an incidence rate of 1.8 cases per one million people in a population. This benign, proliferative disease is a type of tenosynovial giant cell tumor that can affect the soft tissue lining of joints, bursae, and tendon sheaths. These joint-related tumors often present with an insidious onset and non-specific physical exam findings. Therefore, they are often mistaken for other, more common orthopedic injuries, making them difficult to diagnose. Patient Information: A 47-year-old male presented to the orthopedic clinic complaining of right knee pain. The patient had a previous history of gout and a right femur osteochondroma excision. The patient’s primary concern was limited motion for 2.5 years without mechanism or trauma. Results: The patient was initially prescribed a formal course of physical therapy, Meloxicam (a nonsteroidal anti-inflammatory drug aimed at reducing pain and inflammation), and Methylprednisolone (a glucocorticoid aimed at treating inflammation). Six months of nonoperative care led to no improvements. Magnetic resonance imaging displayed an intercondylar notch nodule measuring 4.1 cm. Differential diagnoses included pigmented villonodular synovitis, tophaceous gout, amyloid deposition, or focal nodular synovitis. The patient underwent an arthroscopy, biopsy, mass excision and manipulation under ultrasound. The biopsy determined the definitive diagnosis was idiopathic chronic gout without tophus. Conclusion: With a detailed history, physical exam, appropriate imaging and testing orthopedic abnormalities such as tumors can be appropriately diagnosed and managed. Following up with patients after attempting conservative care is imperative; if they are still reporting limited outcomes, advanced imaging is warranted to determine the underlying cause.
Recommended Citation
Summers, A
(2025)
"Musculoskeletal Tumors Disguised as Orthopedic Injuries: A Case Report,"
Clinical Practice in Athletic Training: Vol. 8:
Iss.
1, Article 13.
Available at:
https://scholars.indianastate.edu/clinat/vol8/iss1/13
Included in
Biology Commons, Body Regions Commons, Diagnosis Commons, Exercise Physiology Commons, Exercise Science Commons, Health and Physical Education Commons, Investigative Techniques Commons, Kinesiotherapy Commons, Medical Physiology Commons, Movement and Mind-Body Therapies Commons, Musculoskeletal, Neural, and Ocular Physiology Commons, Musculoskeletal System Commons, Occupational Therapy Commons, Other Kinesiology Commons, Other Physiology Commons, Other Rehabilitation and Therapy Commons, Physical Therapy Commons, Physiological Processes Commons, Physiotherapy Commons, Recreational Therapy Commons, Research Methods in Life Sciences Commons, Sports Sciences Commons, Therapeutics Commons, Tissues Commons
