Wednesday, December 07, 2011

Exostosis-not always easy to identify!


Young Skeleton with pain after fall  shows exophytic opacity outwards from the metaphyseal location of humerus with undisplaced fractures in the vicinity  with almost 2 Humeral heads appearance   suggesting exostosis with suspicion for   secondary chondrosarcoma  of cartilage cap. MRI is needed for further evaluation.





Teaching points by Dr MGK Murthy, Dr Sumer Sethi.
·         Defined as developmental dysplasia of peripheral growth plate which forms cartilage cap  projection of bone near metaphysis of long bones. Peripheral chondroblast grows  outwards acting as ectopic growth  plate , stopping at maturity
·         Most common benign bone tumor. Any bone forming in cartilage can get involved
·         X ray hallmark is blending of tumor in to  the underlying metaphysis  along with calcification of cap elements 
·         Only 1% solitary  ones can turn secondary chondrosarcoma  at the cap , with  10%  in multiple variety
·         Cartilage cap measuring >1cm in adults and 2-3 cms in children on MRI along with  sudden increase in bone scan uptake in adults  is of concern
·         Other complications include bursal formation

1 comment:

DrAyushGoel said...

It is also k/a OSTEOCHONDROMA.

It is not a TRUE benign tumor,

so
MOST COMMON TRUE benign tumor is Osteoid osteoma.

http://sumerdoc.blogspot.com/2011/05/osteoid-osteoma-ulna.html

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