As a new member, I have a case for which I would like to hear your opinion regarding proper management of this case which I will present to you.
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agement. I've been in private practice for some 19 years and a collea-
gue of mine refers me this 27y/o male with what appears to be an aneurysmal bone cyst on the neck and 2/3 of the body/trochlea of talus on his left foot. It started with an insiduos onset of discomfort along the medial midfoot some 6 months ago, aggravated with ambulation and has progressed to a sharp and throbbing pain, mostly with rest, and gets relief only when wears a Cam Boot. Has tenderness over the talus and TN joint and anterior ankle mortise with lack of dorsiflexion. The MRI diagnosed it as ABC.
I'm considering a 3 phase bone scan, and told my colleague to do first a needle biopsy just to make sure we aren't dealing with a giant cell tumor. My concern is that because ot the extent of the lesion the talus could fracture during surgery, or develops AVN, and to a lesser extent arthrosis incapacitating this young man for life. He works at a Sam,s Club warehouse stocking merchandise all day long.
What are the options??
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