Painful lesion in the proximal Tibia of a 21 year old man

摘要: History and Physical Examination A twenty one year old boy presented to our OPD with pain in his right leg of 3 months duration. Patient complained a dull aching which was present even during rest aggravated by walking. He denied any history trauma there were no associated constitutional symptoms. examination revealed bony tenderness the proximal tibial metaphyseal area obvious palpable mass (Figure 1). The knee had painful full range movement instability. overlying skin free showed cutaneous changes. There distal neurovascular deficits other areas tenderness. Imaging studies including plain radiographs MRI performed 2A B). Based on patient’s history, physical imaging what are differential diagnosis?