A 14 year old girl is presenting for unilateral right leg pain with limp for the past 4 weeks. She has no past medical history. She had trauma when playing football  a week prior to the symptoms. The pain is dull and mainly over night. The patient has no fever. Review of systems (ROS) reveals fatigue but no night sweats or weight loss. The joint exam shows a palpable mass over the right tibia. Labs show an elevation of LDH and alkaline phosphatase. Patient had slightly elevated ESR, CRP and WBC.