USA, CAN     772-600-7827     eva@proimaging472.com

11 yo/female patient softball player present with left groin discomfort. 

No prior trauma,  surgeries,  carcinoma or corticosteroid regimen.

What do you see?

AP VIEW - LEFT HIP.

Medial & slightly superior to the left lesser trochanter, a 1. 7 x 2.0 mm. exostosis is seen with cortices continuous with the parent. Matrix calcification ( multiple radiodense dots) are present. A CT scan was ordered for optimal radiographic evaluation.

XRAY FINDINGS

The appearance of the SI joints is age-appropriate. Unfortunately, clothing artifacts are present. This view allows comparing the normal right to the left which shows a different perspective to the left inter-trochanteric region.

Radiopaedia.org diagram illustrated the relationship of the circumflex branches of the femoral artery to the lesser trochanter. (1) The block dot represents entry point for femoral artery cardiac catherization.

The coronal bone CT scan allows accurate anatomic locationalization of the suspected osteochondroma and its 3D planar capability also allows precise correlation with the neurovascular bundle.

 

DISCUSSIONS: 

A suspected osteochondroma can be evaluated with a non-contrast CT scan of the pelvis (to include the hip joints)(2)

 Malignant transformation of a single osteochroma is low. A cartilage cap thickness > 1.5 cm. (on advanced imaging) should be a suspicious finding for maliginant transformation. (2)

REFERENCES:

  1.  radiopaedia.org
  2. https://pubs.rsna.org/doi/full/10.1148/radiographics.20.5.g00se171407 Osteochondroma: Variants & Complications with Radiologic-Pathologic Correlation