Penn State Milton S Hershey Medical Center, USA
Dr. Isabella A. Ahanogbe graduated from the Ross Univ, Sch of Med, Roseau, Dominica in 2010. She works in Manning, IA and 1 other location and specializes in Family Medicine. Dr. Ahanogbe is affiliated with Manning Regional Healthcare Center and Mercy Medical Center & Childrens Hospital Des Moines.
The patient was a 31-year-oldfemale avidhiker who came into sports medicine clinic for left knee pain, which she has had since July of 2012. She states she was at the beach when her left knee started swelling and aching. Since then she has had intermittent knee pain and would give out for no apparent reason. The pain that she felt was over the anterolateral aspect of her left knee, 2/10 in intensity, an achy pain that was intermittent, and aggravated by going up and down steps and hiking. The patient had a history of a jaw tumor, excised in 2009; pathology was giant cell tumor. Aside from "kissing patellae" and mild tendernessover the left quadriceps tendon, knee exam was normal. X-rays showed non-aggressive appearing radiolucent lesion on the left lateral femoral condyle. MRI showed consistent with either desmoplastic fibroma or fibrous dysplasia. The patient was referred to Orthopedic Surgery. Needle biopsy showed giant cell tumor of bone, confirmed later on final pathology. The patient therefore had multifocal giant cell tumor, a very rare variant of giant cell tumor of bone. Chest CT and bone scan were ordered to rule out metastatic disease. Intralesional curettage, phenol, and allograft bone graft packing of the left femoral lateral condyle lesion was done. Patient was also referred to Hematology for denosumab treatment. On follow-up 3 months after surgery, patient was in Physical Therapy and doing well.