case presentation enchondroma
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5/17/2018 Case Presentation ENCHONDROMA - slidepdf.com
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Case presentation
Dr.AnupkumarAgrawal
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Case
• A 16 yr old male presentated with swellingover little finger of right hand
• No h/o pain
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There is e/olytic /expansilegeographic area
of radiolucency atdiaphysio-metaphysialregion of 5thmetacarpal of right hand andsimilar lesion at
middle phalanx of same digit
There is corticalthinning&endosteal
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Differential diagnosis
most likely diagnosis—Enchondroma Other possibilities are
1. Simple bone cyst
2. Aneurysmal bone cyst
3. Fibrous dysplasia
4. Non ossifying fibroma (FCD)
5. Eosinophilic granuloma
6. Giant cell tumor
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ENCHONDROMA• Age group—10-30yr
• M.C.site –phalanges and metacarpals
• Usually asymptomatic
• Radiological features are
1. Geographic ,expansile lytic lesion
2. Diaphysial –metaphyseal region
3. Centrally placed
4. Stippled or punctate calcification (ring or
arc pattern
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5/16/12 enchondroma involving the
proximal end of the proximal
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5/16/12 Axial computed tomography
image demonstrates a fluffy
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Simple bone cyst• Age group < 20yr (80% cases between 4-
10yr)• M.C.site –long bone –humerus (proximal
metaphysis) rare in small bones
•
Clinically silent until pathological fractureoccurs
•
Radiological features1. Expansile ,lytic geographic metaphyseal
2. Truncated cone appearance
3. Calcification is rare
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Aneurysmal bone cyst• Age 5-20 yr
• M.c.site-long bones-metaphysis
• Radiological features
1. Eccentric expansile,metaphyseal,saccular protrusion of bone
2. thin peripheral cortex
3. Blow out appearance or finger in ballonsign
4. Periosteal new bone formation
5. MRI demonstrate a classic fluid –fluid
ib d l i
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Fibrous dysplasia• Age 3-15yr
• Monostotic and polyostotic
• m.c.bone-ribs,craniofacial &proximalfemur
• Rare in small bone of hand
• Radiological features
1. Diametaphyseal,geographic expansilelucent lesion
2. Ground glass appearance
3. Thick sclerotic margin (rind)
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Im
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Non ossifying fibroma• age group
• Fibrous cortical defect-4-8yr• Non ossifying fibroma-8-20 yr
• M.c. bone –long bones-around knee joint
• Diametaphyseal region
• Rare in small bone of hand&feet
• Radiological features
1. Eccentric,expansile ,flame shaped
2. Thinning of cortex,endosteal scalloping
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Eosinophilic granuloma• Age group <20yr
• M.c. bone –skull (axial skeleton)• Rarely small bone of hand
• Radiological features
1. Solitary Geographic expansile lytic ,roundto oval
2. Endosteal scalloping ,cortical thinning
3. Sharply demarcated borders
4. Hole within hole appearance(beveling of edges)
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ph
il
ic
gra
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Lateral skull radiograph in a30-year-old woman with
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Giant cell tumor• Age group -20-40yr
•
M.c.site –long bones-distal femur• Rare in small bones of hand
• Metaphyseal-epiphyseal
• Begins in metaphysis and then extends tosubarticular location
• Radiological features
1. Eccentric,expansile ,geographic lytic
2. Cortical thinning and wide zone of transition
3 Soap bubble appearance(heavy
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