Fracture of enchondroma

 

Doctor's Information

Name : Morteza
Family : Sanei Taheri
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Resident : Elham Esmi

 

Patient's Information

Gender : Male
Age : 35

 

Case Section

Muskuloskeletal System

 

Clinical Summary

A 35 -years-old man with pain in digit.

 

Images

 

Imaging Procedures and Findings

X-RAY: There is a intramedullary lytic expansile lesion in proximal phalanx of second finger, the zone of transition is sclerotic. Cortical disruption associated with mild displacement is due to fracture.

 

Discussion

Cartilaginous tissue is not radiopaque. The characteristic feature is a single well-defined demarcated zone of radiolucency in the medulla. In the small bones of the hand and feet tumors are particularly likely to expand and thin the overlying cortex ,but without its destruction or the development of a periosteal reaction other than that following a fracture. The zone of transition is narrow and sclerotic. The endosteal margin may be scalloped. As in all neoplasm of cartilaginous origin, flecks of calcification are frequently present within the tumor, especially as they become more mature. Lesions rarely extend to the ends of the affected bones and are often situated in the distal portions. Very few other osteolytic lesions in the bones of the hands are likely to cause diagnostic difficulty, apart from the rare implantation dermoid cyst in a terminal phalanx or perhaps fibrous dysplasia. These cartilaginous tumors are unremarkable scintigraphically, and angiographically their low vascularity is readily demonstrated; a marked increase in photon activity on a bone scan should raise the possibility of a pathological fracture or chondrosarcoma. The high water content of the hyaline cartilage matrix results in particularly high signal intensity on T2-weighted MR images that often have a lobulated contour. MRI, like other radiological techniques, cannot distinguish between a benign cnchondroma and a low grade chondrosarcoma with certainly.

 

Final Diagnosis

Fracture of enchondroma

 

References

Sutton 2003

 

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