Fig. 4.

Imaging in a 15-year-old female patient, a) radiograph at presentation, showing a pathological fracture through a malignant-appearing lesion of the proximal femur, b) coronal STIR T₁-weighted post-contrast MRI showing the fracture, associated haematoma and soft-tissue mass, after which a biopsy confirmed a diagnosis of Ewing sarcoma. The patient underwent six weeks in traction (c) and six further weeks in a spica cast (d). After neoadjuvant chemotherapy, the fracture healed (e) and patient underwent a wide resection of a proximal femoral mass with endoprosthetic replacement (f).