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Case 3 – Left Ankle

A 19-year-old male presents to a DC office complaining of non-specific left ankle discomfort—no prior history of trauma, surgery, carcinoma, or corticosteroid/opioid regimen.

A typical endonchroma would typically be located in the metacarpals.

Did you see the density within the left distal fibular radiolucency?

This is a key to enchondroma type lesions. The sagittal MRI confirms posterior expansion with extension distally not appreciated on plain radiographs.

A low-grade chondrosarcoma may be a key differential consideration, however.

A soft-tissue mass, periosteal reaction, cortical disruption in the juxta-articular fibula,  cortical thickening, and tumor size greater than 4.0 cm indicate chondrosarcoma over enchondroma of the fibula.1


  1. Radiographic differentiation of enchondroma from low-grade chondrosarcoma in the fibula. Kendell SD1, Collins MS, Adkins MC, Sundaram M, Unni KK

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