Module 15, General Orthopaedist Level

This is a 7 year old girl who has had polyarticular Juvenile Rheumatoid Arthritis for over a year. Most recent management has been with prednisone, methotrexate and tolectin. The symptoms improved with little evidence of ongoing synovitis. A mass in the left bicipital area was first noticed at the age of 7 years and 9 months and has increased in size over several months.

Question 15A

An x-ray was obtained which demonstrated a soft tissue mass. No further work up is indicated.

Question 15B

An ultrasound suggested this is a solid mass. Biopsy is now indicated.

Question 15C

An MRI suggests that it is attached to the shoulder joint. Therefore this is probably a synovoma.

Question 15D

A needle biopsy is the way to make a definitive diagnosis.

Question 15E

An arthrogram would be the best test to follow the ultrasound report.

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