24 years old male with right knee pain and antalgic gait. Lateral knee X-ray shows sclerotic bone lesion in proximal metaphysis of tibia. #radiology #mskrad #radres #MedTwitter

8 months later, significant growth is seen, extending to the epiphysis of tibia. Note also small soft tissue extension posteriorly. #radiology #mskrad #mskradiology #radres #radiologyresident #radiologybmj

MRI shows the hypointense enhancing lesion in metaphysis and epiphysis of proximal tibia. Note peri-lesional edema (yellow arrow) and soft tissue extension (red arrows). #radiology #mskradiology #mskrad #radres #MedTwitter

Small calcified lung nodule is seen on thorax Ct (may 2017) Note significant enlargement of nodule in 2 month, additional nodules are also seen , consistent with metastasis of Osteosarcoma. Biopsy was consistent with osteosarcoma( May 2017) . #radiology #radres #mskrad