Text in Italics is general (instructional) information
The Xray view shows sclerosis of the shaft of the femur and a periosteal reaction. The sclerotic bone lesion in a child can sometimes be difficult to diagnose without a biopsy. If malignancy is suspected a biopsy is mandatory.
The differential diagnosis includes Chronic osteomyelitis, Ewing's and a haematological malignancy. The ESR can also be raised in these conditions. Other causes of a periosteal reaction are stress fractures and an osteoid osteoma. It was necessary to biopsy the femur to exclude malignant causes.