Osteochondroma

Case contributed by Dr Robert Foley

Presentation

1.5cm x 3cm hard lump on medio-proximal end of tibia, non-mobile, has been there in the last 6 months at least

Patient Data

Age: 11 years
Gender: Female
Ultrasound

Medial proximal tibia

The clinically palpated lump correlates to a bony over growth from the medial proximal tibia with a cartilage cap measuring 4mm in maximal thickness. This is in keeping with an osteochondroma.

X-ray

Left knee joint

Bony exostosis arising from the medial aspect of the proximal tibial metaphysis in keeping with an osteochondroma. 

Case Discussion

It is essential to measure the thickness of the cartilaginous cap in cases of osteochondroma. This can be performed with ultrasound or MRI. A thickness of >1.5cm is a worrying feature for malignancy (low-grade chondrosarcoma). Other features suspicious for malignant degeneration can be remembered with the mnemonic GLAD PAST (see related articles). 

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Case information

rID: 80117
Published: 16th Jul 2020
Last edited: 18th Jul 2020
Inclusion in quiz mode: Included
Institution: University Hospitals Bristol

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