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Fournisseur Duke orthopaedics presents wheeless' textbook of orthopaedics site map search site by word home advertising info editorial board contact us my account chondroblastoma - see: bone tumor menu - discussion:     - age at presentation:           - most common primary epiphyseal tumor in children is chondroblastoma;           - most commonly arises between ages 10 to 30;           - not infrequently, the tumor will also arise in adults;           - the adults counterpart of chondroblastoma is giant cell tumor;           - in the report by ramappa aj, et al, 62 % of the 47 patients were 20 of age or younger (in contrast, 38% of patients will be well beyond skeletal maturity);     - location:           - lesions are distributed widely in the skeleton, but most were in the epiphyses or apophyses;           - most lesions occur in the proximal part of the tibia (17%) and the proximal part of the humerus (15%); (ramappa aj, et al)           - may occur in the apophysis of the greater trochanter;           - of note, chondroblastoma is the most common tumor affecting the patella, followed by giant cell tumor;             - metastatic lesions are uncommon but due occur;     - males more affected than females;     - diff dx:           - only three tumors may invade physis: chondroblastoma, gct, and clear cell chondrosarcoma;           - gct of bone:                   - gct usually arises in the 3-4 decade (where as chondroblastoma arises in the second);                   - gct may expand to both the epiphysis and diaphysis;           - clear cell chondrosarcoma (see chondrosarcoma)                   - clear cell sarcoma is rare, slow growing, locally recurrent tumor easily confused with chondroblastoma but malignant;           - epiphyseal osteomyelitis: (see: osteomyelitis);                   - ref: primary subacute epiphyseal osteomyelitis. viagra use timing viagra without prescription viagra without a doctor prescription viagra use timing - clinical presentation:     - painful - motion limiting, benign tumor arising during adolescence;     - majority are active stage 2 lesions; - radiographs:     - look for epiphseal radiolucent lesion w/ fine punctate calcifications (mineralization and a well-marginated rim of reactive bone);     - oval osteolysis located eccentrically in the epiphysis;     - slight bone expansion and broading of cortex;     - tumor is usually bordered by a well defined margin of reactive bone. viagra use timing generic viagra canada buy viagra without prescription     - note the amount of epiphyseal involvement and whether the tumor crosses the growth plate;     - stage 3 chondroblastoma may extends thru growth plate into metaphysis or through articular cartilage into. viagra generic generic viagra cost viagra generico funciona cheap generic viagra where 2 buy viagra new jack box commercial viagra
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