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20 yo/F presents with left wrist discomfort ~ 12 months duration. Left ulnar N distribution discomfort that awakes her. No prior surgeries, carcinoma or corticosteroid regimen.

What do you see?

Nodular density- proximal to left hypothenar region.

Bone or soft tissue?

Oblique view of left wrist.

Questionable density seen on volar aspect with wrist with distal ulnar resorption.

Semi-supinated view of the left wrist
(Norgaard's position)

Radiographic features: exostosis with chondroid matrix, parent
cortex continuous with lesion. All features consistent with
osteochondroma of volar left wrist.

CLINICAL FOLLOWUP:

Once the degree of encasement of the osteochondroma was verified with imaging, surgical intervention resulted in a successful clinical outcome.

DISCUSSION: Osteochondroma represents the most common bone tumor is an aberration of enchondral ossification, NOT a true neoplasm. (1) Complications include: cosmetic and osseous deformity fracture, neurologic sequlae as in our case.

KEY FACTS: (2)
  • Bony protrusion covered by a cartilaginous cap.
  • Growth in childhood takes place in the cap, corresponding to normal enchondral growth at the growth plates.
  • A thick cartilaginous cap in an adult is suspicious of chondrosarcoma.

REFERENCES:

  1. Sep 1 2000   https://doi.org/10.1148/radiographics.20.5.g00se171407

    Imaging of Osteochondroma: Variants and Complications with Radiologic-Pathologic Correlation

  2. https://radiologyassistant.nl/musculoskeletal/bone-tumors/alphabetical-order/bone-tumor-h-o#osteochondroma

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772-600-7827
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