Female patient in her 40s diagnosed 6 months ago with langerhans cell histiocytosis after a biopsy of her femur. pain ++. investigations? treatment?

CT/MRI and Curettage: Blood tests should include FBC, clotting studies, U&E, LFT, urine osmolality. Plain X-ray or CT/MRI scans if evidence on new bony involvement. Endoscopy if GI involvement and bronchoscopy if pulmonary lesions suspected. Surgical curettage is the usual treatment or can try radiotherapy, intralesional steroids, bisphosphonates. Chemotherapy for crucial anatomical sites (vinblastine/prednisone)

Histiocytosis Femur: LCH is rare disease that gives osteolyitc lesions due to proliferation of histeocytes, usually affect the bones resulting in pain and fractures diagnosis is difficult and is based on tissue diagnosis by biopsy treatment if femoral disease involve stabilisation and radiation also chemotherapy can be used in the treatment

Haematologist: I've seen it once. Can be quite painful and occasionally I believe they consider RT. Worth a discussion with a haematologist.

Need more history: A few issues: 1) Diagnosed 6 months ago after a biopsy - are we talking about a result that has been missed for 6 months and now presenting for 1st time? If so, then she should be referred to hospital for urgent bloods, pain relief and radiotherapy. 2) Or is this a flare up of her ongoing problem - if so, then she will need repeat bloods and Xray (to rule out pathological fracture and proceed)