title: Osteosarcoma in the distal femur two years after an ipsilateral femoral shaft fracture: a case report.
abstract: BACKGROUND
  The duration of symptoms preceding a definitive diagnosis of osteosarcoma is quite long. Pathological radiological signs are often evident by the time of diagnosis. Although several case reports have been published on osteosarcoma of the femur, to the best of our knowledge this report is the first one with such an unusual clinical course.
  
  
  METHODS
  We describe the case of a 58-year-old Caucasian man who presented with a femoral shaft fracture. Two years post-trauma osteosarcoma in the ipsilateral distal femur was diagnosed. Was it coincidence? We think that the history of the trauma is crucial to answering this question.
  
  
  CONCLUSIONS
  This case report underlines the need to keep up awareness of pathological fractures in emergency medicine and trauma surgery. When radiographs do not raise any suspicion but the history of trauma or the physical examination does, we recommend further radiological and/or histological diagnostic examinations.
authors: Department of Orthopedic Surgery, University Medical Center Groningen, University of Groningen, PO Box 30,001, NL-9700 RB Groningen, The Netherlands. o.dorrestijn@orth.umcg.nl.
authors: Oscar
authors: O
authors: Dorrestijn
authors: Paul C
authors: PC
authors: Jutte
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