So in most cases there is no treatment required except regular monitoring so as to identify any changes or complications. A case report of osteochondroma with unusual clinical and. An osteochondroma is made up of both bone and cartilage and is the outgrowth of growth plate. Osteochondroma is a bony excrescence with welldefined limits, having a thin outer cortex and an internal cancellous structure. Drawing shows an osteochondroma arising from the lateral aspect of the distal femur with a hyaline cartilage cap and overlying bursa.
There are already plenty of good books out there on introductory musculoskeletal radiology. Mr is the best imaging modality for visualizing the effect of the lesion on surrounding structures and for evaluating the hyaline cartilage cap. Osteochondroma is a bony developmental anomaly which forms due to exophytic protuberance on the surface of growing bones. Imaging of osteochondroma rsna publications online. The system is intended to provide practice to physicians, fellows and residents in the interpreptation of radiological images from a variety of different cases.
The most frequent localization is in the long bones. Specifically, the bone in question belongs to a near complete, fairly well preserved skeleton buried in tomb 82 of calle gallo, a multiple tomb containing the remains of three adult and five immature individuals. General instructions for spotters recommended book for spotters. Its peak incidence is in the second decade of life. In the trunk, more frequently involved are the scapula and ilium. Osteochondroma is the most common primary bone tumor comprising more than onethird of all benign bone tumors. Mar 02, 2020 an osteochondroma is a cartilagecovered bony excrescence exostosis that arises from the surface of a bone.
Cartilage caped exostosis osteocartilaginous exostosis osteochondroma is a bony exostosis projecting from the external surface of a bone it is usually has a hyaline lined cartilaginous cap the cortex and spongiosa of the lesion merge with. Tests for osteochondroma can also identify diseases such as secondary peripheral chondrosarcoma and multiple osteochondromatosis. Join our telegram group and channel for more radiology cases. Radiology cases quiz consisting of 10 radiology spotters. This process is experimental and the keywords may be updated as the learning algorithm improves. Multiple osteochondromas hereditary multiple osteocartilaginous exostoses, diaphyseal aclasis epiphyseal osteochondroma dysplasia. Complete excision of osteochondroma is usually curative. They can present with progressive deviation of the mandible to the opposite side with restriction of function. The most feared sequelae of an osteochondroma is malignant transformation to a chondrosarcoma, and this occurs between approximately 1% if solitary and sporadic to 525% of the time hereditary osteochondromatous syndromes, such as hereditary multiple exostoses i. The pathognomonic radiographic feature is that the cortex of the host bone flares into the cortex of the osteochondroma, and the cancellous bone of the osteochondroma blends with the cancellous bone of the metaphysis. Because, it seemed to me that most of these books were doing a great job of telling one about diseases, but not how to approach their diagnosis. Radcases and aunt minnies atlas and imagingspecific diagnosis. Osteochondroma is the most common benign tumor or tumorlike lesion of bone.
Please practice handwashing and social distancing, and check out our resources for adapting to these times. Cooper, md, radiology medical group, san diego, california email protected. Osteochondroma is exceptional in the hand and foot, and it does. Radiationinduced bone tumours include osteochondroma and sarcoma, most commonly osteosarcoma. Definition osteochondroma is a bony exostosis projecting from the external surface of a bone. An osteochondroma can be either sessile or pedunculated and is seen in the metaphyseal region typically projecting away from the epiphysis. Radiology museum depicting important events in radiology history like roentgens journey of discovering xrays. No treatment is required unless the tumour interferes with. Jun 30, 2011 the cartilaginous cap deserves the most attention when differentiating a benign osteochondroma from a secondary chondrosarcoma that arose from a preexisting osteochondroma. In adults, the cartilaginous cap regresses and becomes thin due to enchondral ossification of the majority of the cap. They are cartilagecapped bony projections from the external surface of a bone. An osteochondroma can affect any bone preformed in cartilage.
Osteochondroma is the most common benign bone tumor. Cardiac radiology genitourinary radiology learning radiology. Osteochondroma and osteochondromatosis hereditary multiple. Histologically an osteochondroma consists of a cartilage cap there should be no mitotic cells. Illustrative cases have been carefully selected from thousands processed at the orthopedic department of beijing jishuitan hospital, which holds a leading position in orthopedics in china. It may be solitary or multiple hereditary multiple exostoses. X ray sessile variant creates a broad based exostosis. Osteochondroma or osteocartilaginous exostosis is the most common benign tumor of bone. A bone development abnormality characterized by the development of a benign bone tumor that occurs on the ends of long bones. Osteochondromas are the most common benign bone tumors and are comprised of a bony prominence with a cartilaginous cap. General instructions for spotters the recommended book for spotters. Cartilage caped exostosis osteocartilaginous exostosis osteochondroma is a bony exostosis projecting from the external surface of a bone it is usually has a hyaline lined cartilaginous cap the cortex and spongiosa of the lesion. It is usually has a hyaline lined cartilaginous cap the cortex and spongiosa of the lesion merge imperceptibly with that of the host bone d. Abnormal outgrowth of bone and cartilage associated with growth plate.
This book is an ideal guide for anyone who deals with msk mri on a regular basis, including general radiologists who have not completed a dedicated musculoskeletal radiology fellowship, radiologists who would want to brush up on their msk mri reading and reporting skills. A skull base osteochondroma benign exostosis in a 38yearold man is reported. The tumor can occur singly or in multiples and in rare instances the tumors may become malignant. The tumor is often diagnosed as an incidental finding. Radiographically, enchondromas appear as geographic, mildly expansile, lytic lesions, which may lead to mild cortical thinning. Osteochondromas are cartilagecovered, histologically normal bony projections exostoses on the external surface of a bone in the vicinity of growth plates. The shape of the proximal femur resembels that of the staff carried by herders shepherds, which is known. A case report of osteochondroma with unusual clinical and imaging.
Part of the series in radiology book series sera, volume 20 abstract. In adults, the cartilaginous cap regresses and becomes thin due to. Diagnostic radiologymusculoskeletal imagingtumors basic. Chapter 83 covers osteochondroma, and includes information on definition, demographics, clinical features, anatomy, imaging modalities and features, imaging algorithm, applied physics, differential diagnoses and pitfalls, and a bulleted summary of key points. When the child is fully developed, the osteochondroma also stops growing. The zone of transition is narrow, although it can be lobular. Radiology books for entrance exams like neetaiims pgi. Osteochondroma pediatric orthopaedic society of north. It usually grows as the child grows and stops when the child reaches skeletal maturity.
Although usually thought of as a benign bone tumor, they may be thought of as a developmental anomaly. There is often associated broadening of the metaphysis from which it arises. Continued lesion growth and a hyaline cartilage cap. An osteochondroma is a cartilagecovered bony excrescence exostosis that arises from the surface of a bone. Osteochondroma is the most common benign bone tumor and the most common skeletal neoplasm. This book covers typical imaging features of benign and malignant bone tumors in the hip and knee.
Exophytic lesion of bone surface composed of a stalk of mature bone with a cartilaginous cap. Condylar osteochondromas are typically situated on the anteromedial surface of the condylar head. They account for approximately 35% of all benign bone tumors and 9% of all bone tumors. To appreciate the role of forensic radiology in a disaster victim identification process. Pathogenesis and aetiology of this tumour have not been well understood. We present a case of a 37yearold patient with preauricular pain and a progressive mandibular deformity secondary to a. Recognizing the basics with student consult online access. It constitutes 20%50% of all benign bone tumors and 10%15% of all bone tumors. Ossification of the posterior longitudinal ligament opll osteitis condensans ilii. Similar to osteochondroma, deh is diagnosed prior to 15 years of age and the growth of lesions end at puberty, when the growth plates close. A growth plate is cartilage near the ends of long bones, such as the thigh bone. Malignant transformation is seen in 1% of solitary osteochondromas and in 3%5 % of patients with hme.
Osteochondroma is a disease of growing bone and thus typically presents in younger patients. Osteochondroma represents the most common bone tumor and is a developmental lesion rather than a true neoplasm. The cartilaginous cap deserves the most attention when differentiating a benign osteochondroma from a secondary chondrosarcoma that arose from a preexisting osteochondroma. Osteochondromas often develop near the growth plate of a bone during childhood. After reading this article and taking the test, the reader will be able. Mr or ct imaging can demonstrate cortical and medullary continuity between the osteochondroma and the parent bone as a distinctive feature.
Osteochondroma is the most common primary bone tumor comprising. There is a pedunculated osteochondroma measuring approximately 3. Most often, it affects the long bones in the leg, the pelvis, or the shoulder blade. An osteochondroma is a benign noncancerous tumor on the surface of your bone. Osteochondromas, which are the most common bone tumors in children, may be solitary or multiple, and they may arise spontaneously or as a result of previous osseous trauma. Plain xrays will show a bony outgrowth, either with a narrow or broad base. Management of the patient with an osteochondroma either as. Secondary chondrosarcoma from osteochondroma in proximal humerus.
To learn about the methods using forensic radiology in a disaster victim identification process. Recommended reading for firstyear radiology residents. The presentation is a brief overview of the condition however its uncommon variants are not included. Data on the occurrence of osteochondroma show that the reported incidence of costal osteochondroma is very low. Osteochondroma is an overgrowth of cartilage and bone that happens at the end of the bone near the growth plate. The cell of origin of osteochondroma development remains a point of debate among researchers, as research by different groups indicates either a proliferating cell of the growth plate or mesenchymal stem cells of the periochondrium as the cell of origin. It arises in bones preformed by endochondral ossification and the most common site of involvement is the metaphyseal region of the long. Mri was not only very useful for determining the extent of the tumour, but also showed its fat content and, on contrastenhanced fatsuppressed images, its vascularity. Osteochondroma of the mandibular condyle temporomandibular. No treatment is required unless the tumour interferes with function, in which case it should be. It can be easily diagnosed with the help of xrays and mri. No joint effusion or abnormal soft tissue calcifications. Osteochondroma, solitary benign tumour that consists partly of cartilage and partly of bone.
Welcome to the radiology assistant educational site of the radiological society of the netherlands by robin smithuis md. Most recommended book by residents who have cleared neet recently. Osteochondromas are one of the most common benign bone tumours. To discuss added value of forensic radiology in a disaster victim identification process. Metachondromatosis is a rare disorder that exhibit symptoms of both multiple osteochondromas and enchondromas in. Debate continues as to whether osteochondroma is a developmental disorder pseudotumoral lesion or a neoplasm. They are the most common benign bone lesions and present during late childhood and adolescence. Osteochondromas are common and may develop spontaneously following trauma or may have a hereditary basis. Extensive calcification with radiolucent irregularities of the cap implies possibly malignant change.
Osteochondroma, also referred to as osteocartilaginous exostosis or plainly exostosis, is the most common benign bone tumor. A few of these are camera pictures, none the less these are typical cases. Symptoms, if any, are determined by the location and size of the tumor. Radcases and aunt minnies atlas and imagingspecific diagnosis here is the list of rest of the radiology casesspotters. A case report nf erdem1, m manisali2 abstract introduction osteochondroma is a slowly growing benign tumour that is rarely seen in the maxillofacial region.
Learningradiology osteochondroma, tumor, bone, benign. The leading introductory radiology text for medical students and others who are required to read and interpret common radiologic images, learning radiology, 4th edition, stresses an easytofollow pattern recognition approach that teaches how to differentiate normal and abnormal images. The presence of multiple lesions is associated with multiple hereditary exostosis mhe and the ext genes. It has rarely been described in middleaged and elderly patients.
The spinal canal is a narrow, compact space containing important structures, and even a relatively small lesion can lead to potentially serious complications. In large, secondary chondrosarcoma arises at the site of osteochondroma due to increased thickness of the cartilage cap indicating potential malignant transformation. Most multiple osteochondroma patients also suffer from a variety of orthopaedic deformities like shortening of the ulna with secondary bowing of the radius 3960%, inequality of the limbs 1050%,varus or valgus angulation of the knee 833%, deformity of the ankle 254% and disproportionately short stature. Osteochondromas of the spine are rare and are unique from their counterparts in the long bones and elsewhere. Here are instructions about radiology cases and spotters. Secondary chondrosarcoma from osteochondroma in proximal. A shepherds crook deformity refers to a coxa varus angulation of the proximal femur, classically seen in femoral involvement by fibrous dysplasia, although may be seen in other disorders such as paget disese of bone and osteogenesis imperfecta. It originates from the metaphysis, but, with skeletal growth, it tends to move toward the diaphysis. Learning mr physics early will help you make the most of your mr rotations if you program relegates you to reading plain films for your first nine months, then nevermind.
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