Module 15, Pediatric Orthpaedist 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. An arthrogram of the left shoulder joint demonstrated extension of dye down the bicipital groove and into the mass in the upper arm.

Question 15A

You would expect that the mass would increase in size after the arthrogram.

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Question 15B

The ultrasound suggested that this is a solid mass. But the arthrogram confirms communication. Further work up is not indicated..

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Question 15C

These masses become chronic problems and should be surgically excised.

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Question 15D

The medications taken by this child increase the concern about the diagnosis of a mass.

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Question 15E

If the arthrogram did not demonstrate a communication, a biopsy of the lesion is indicated..

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