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A ski instructor who tripped on a "snow snake"

Enviado por henry el Mié, 10/21/2009 - 08:19.
Case Identification
Case ID Number: 
10212009SS
Periosteal Reaction: 
absent
Benign/Malignant: 
unknown
Clinical case information
Case presentation: 

A 42 year old man who works as a ski instructor at a ski area near Boston presents to the emergency room after suffering an injury to the right hip. He states that he was skiing through a thin layer of new snow on top of the base snow pack when his right ski caught on something, twisting his leg, at which point he felt something very painful happen to his right hip. He fell down and was unable to stand. He said he though he might have caught a "snow snake."

Radiological findings:: 
A fracture is seen through the neck of the right femur, where a lesion can be noted in the femoral head. No other bone lesions are present.
Differential Diagnosis: 
What is the differential here?
Further Work Up Needed:: 
Should this patient have surgery for the fracture combined with biopsy, or some other treatment plan?
Pathology results:: 
Biopsy material is shown. What is the diagnosis?
Image Reference: 
Clear Cell Chondrosarcoma
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