Pdf shoulder pain due to enchondroma of the humerus humerus. William herrings clear, conversational writing style employs a touch of humor to explain what you. The study included 96 patients with cartilage type lesions suggestive of an enchondroma e or an low grade chondrosarcoma lgc according to the clinical and. Cardiac radiology genitourinary radiology learning radiology. Enchondromas usually reside within the medullary canal of the bone and do not grow.
In this kind of injury, the left and right halves of the pelvis are separated at front and rear, the front opening more than the rear, i. Differentiation on mri between enchondroma and chondrosarcoma was the subject of two separate studies. Shoulder pain due to enchondroma of the humerus humerus enkondromuna bagl. Radiographic differentiation of enchondroma from lowgrade. Enchondroma is one of the most common osseous neoplasms. Distinguishing enchondroma from lowgrade central chondrosarcoma depends on interpreting histologic findings in the light of clinical and radiologic features.
Can imaging criteria distinguish enchondroma from grade 1 chondrosarcoma. Students benefit from the extensive knowledge and experience of esteemed author herring and ensure their mastery of the material with additional online content, bonus images, and selfassessment exercises at student consult. We also describe practical imaging aspects of the remaining chondroid tumors. The study included 96 patients with cartilage type lesions suggestive of an enchondroma e or an low grade chondrosarcoma lgc according to the. It is a benign condition and most of the time does not cause any symptoms and rarely does it require any treatment. If there are no signs of bone weakening or tumor growth, observation may be suggested. This is a classic appearance of an enchondroma in a phalanx on radiographs. Usually solitary, although they can occur as multiple. Definition of enchondroma enchondromata in the dictionary. Enchondroma vs low grade chondrosarcoma radiology reference. When a tumor is unusually large or when multiple tumors are present, however, a person can suffer from a bone fracture or deformity. Distinguishing enchondroma from lowgrade central chondrosar. Our cases and the previously published ones lead us to believe that enchondroma protuberans is probably an enchondroma variant and that its unusual growth pattern may be related to the oblique orientation.
Radcases and aunt minnies atlas and imagingspecific diagnosis. Enchondroma frontal radiograph of the right hand reveals a. Please tell us where you read or heard it including the quote, if possible. In my opinion, the first order of business is to learn the names of all of the tumors and tumorlike. Sagittal t1weighted a, trte, 36720 and fatsuppressed proton densityweighted b, 2,250 mr images show focal area of marrow replacement with high signal intensity on longtr image arrows in distal femoral metaphysis. Enchondroma versus chondrosarcoma in the appendicular. Usually asymptomatic or pain due to pathologic fracture age 20 49 years, no gender preference may be due to displaced growth plate sites. Enchondroma is a benign cartilage tumor arising within the medullary cavity and originating from cartilage rests displaced from the physis. Enchondroma frontal radiograph of the right hand reveals.
Incidental enchondromas of the knee june 2008, volume 190 number 6. Know the causes, symptoms, treatment and prognosis of enchondroma. An enchondroma is a benign tumor that appears in the cartilage tissue found inside a bone. Can imaging criteria distinguish enchondroma from grade 1. Enchondroma radiology orthopaedicsone images orthopaedicsone. Apr 7, 20 enchondroma frontal radiograph of the right hand reveals a lytic lesion in the fourth proximal phalanx yellow arrow with subtle areas of calcified matrix within the lesion compatible with an enchondroma. M d murphey, d j flemming, s r boyea, j a bojescul, d e sweet, h t temple. Recognizing the basics, containing new chapters on ultrasound, interventional radiology and mammography as well as online. We contrast a case of enchondroma protuberans with two cases of coincident enchondroma and osteochondroma. The distinction should be made based on answers to the question, is the lesion growing. Join our telegram group and channel for more radiology cases.
There is limited intrinsic ability of imaging criteria to distinguish enchondroma from lowgrade chondrosarcoma. They have also been reported to cause increased uptake on pet examination. Distinguishing between enchondromas and lowgrade conventional chondrosarcomas is a frequent difficulty as the lesions are both histologically and radiographically very similar. Enchondroma enkondroma is a type of benign noncancerous tumor that begins in the cartilage found inside the bones. Article pdf available march 2011 with 1,765 reads how we measure reads.
In this kind of injury, the left and right halves of the pelvis are separated. The xray volume of the enchondroma overlaps the volume of the lesion as seen on mri. Review of musculoskeletal radiology teaching files on the internet. An awardwinning, radiologic teaching site for medical students and those starting out in radiology focusing on chest, gi, cardiac and musculoskeletal diseases containing hundreds of lectures, quizzes, handout notes, interactive material, most commons lists and pictorial differential diagnoses. Enchondroma medical definition merriamwebster medical. In the long bones, enchondromas do not grow, whereas lowgrade chondrosarcomas grow slowly. The more difficult diagnostic dilemma is distinguishing enchondroma from lowgrade chondrosarcoma. Some authors make a distinction between ollier disease and enchondromatosis on the basis of distribution. Enchondroma definition, a growth of cartilage within the shaft or substance of a bone. Enchondroma and chondrosarcoma request pdf researchgate. An enchondroma is a benign cartilage tumour found inside bones.
Osteomalacia and ricketsrare believed to be secondary to humoral substance elaborated by lesion which decreases threshold for phosphate resorption 3. Here are instructions about radiology cases and spotters. It often affects the tiny long bones of the hands and feet. Intense uptake occurs with an underlying pathological fracture or cortical expansion in small bones 5. Benign and malignant cartilage tumors of bone and joint. An enchondroma can be thought of as an island of cartilage within the bone that never transformed into normal bone. There is no surrounding lucency, cortical destruction, periosteal reaction or soft tissue mass. An enchondroma most often affects the cartilage that lines the inside of the bones.
Enchondroma versus chondrosarcoma in the appendicular skeleton. List the radiologic spectrum of primary chondrosarcoma. Incidental finding of a left proximal humerus lesion. This is often the result from a heavy impact to the groin pubis, a common motorcycling accident injury. Enchondromas are cartilaginous tumors of the benign bone tumor family. Ct scan for enchondroma computed tomography scan ct scan computed tomography scan ct or cat scan is a noninvasive diagnostic imaging procedure that uses a combination of special xray equipment and sophisticated computer technology to produce crosssectional images often called slices, both horizontally and vertically, of the body. This book is distributed under the terms of the creative commons. Regression is highly unusual, and loss of matrix mineralization in an existing enchondroma should prompt investigation for malignant transformation. Our team has developed an expert strategy to successfully. It may also affect other bones such as the femur thighbone, humerus upper arm bone, or tibia one of the two lower leg bones. Chondroid tumors as incidental findings and differential diagnosis.
General instructions for spotters the recommended book for spotters. Pdf shoulder pain due to enchondroma of the humerus. Lytic lesion with well defined margins, no periosteal reaction and popcorn like. A rare occurrence of enchondroma in neck of femur in an. Enchondroma, solitary benign cartilaginous tumour that occurs mostly in the shafts of bones of the hands and feet, usually between adolescence and about age 50.
A small focus of cholesterol clefts with giant cells is present. Treatment for enchondroma may include surgery and bone grafting. Part of the series in radiology book series sera, volume 20 abstract. Ap and lateral conventional radiographs demonstrate a 33x16mm subtle collection of disorganised punctate calcification in the medullary bone of the left distal femoral metadiaphysis. Enchondromas have a characteristic appearance on magnetic resonance imaging mri as well. Jul 16, 2015 by martin timchur radiographic findings. Distal femur and proximal humerus are other less common locations. Learning radiology, 3rd edition is a musthave for anyone who will be required to read and interpret common radiologic images. Increased uptake on the bone scan can be seen with enchondromas. More importantly, local pain related to the lesion is always concerning for malignancy. As they grow, they expand and thin the cortex of the parent bone, producing considerable deformity. Enchondroma consists of 310% of all bone tumours, while they constitute 1224% of benign bone tumours. The bones most often involved with this benign tumor are the miniature long bones of the hands and feet.
The latter are usually larger, occur in less typical places, generally occur more proximal, and may have deeper and more pronounced endosteal scalloping. Definition and pathogenesis thought to arise from central growth plate cartilage that fragments from trauma, a congenital defect, or a developmental abnormality importance distinguishing enchondroma from lowgrade chondrosarcoma can be extremely difficult. It may also affect other bones such as the femur thighbone, humerus upper arm bone, or tibia one of the two lower leg. Resources on enchondroma radiology and related topics in orthopaedicsone spaces. The leading introductory radiology text for medical students and others who are required to read and interpret common radiologic images, learning radiology, 4th edition, stresses an easytofollow pattern recognition approach that teaches how to differentiate normal and abnormal images. Dec 01, 2015 enchondroma is a solitary, benign, intramedullary cartilaginous tumour occurring most commonly in small bones of hands and feet. Enchondromas are the second most common benign tumor of bones after osteochondroma and most common benign tumor of. Jaffecampanacci syndrome rare multiple nonossifying fibromas and multiple extraskeletal manifestations including cafeaulait spots, mental retardation. Radiology marketing services available to radiology centers. Enchondromas are among the most common benign tumors seen in the skeleton. Pdf learning radiology download full pdf book download.
Enchondroma versus lowgrade chondrosarcoma in appendicular. Recognizing the basics order the 4th edition of the bestselling textbook learning radiology. This appearance is indicative of a lesion of cartilaginous differentiation. An enchondroma is a benign cartilaginous tumor that arises from the medullary space of the bone. Enchondromas rarely cause pain or other symptoms, so most remain undiagnosed until xrays are taken for an unrelated injury or condition.
Differentiation of an enchondroma from lowgrade chondrosarcoma is problematic, as they can have similar appearances. To evaluate demographic and radiographic features that may differentiate between enchondroma and lowgrade chondrosarcoma of the fibula. How to diagnose enchondroma, bone infarct, and chondrosarcoma. Enchondroma is a type of benign bone tumor that originates from cartilage. Lucent lesions of bone uw radiology university of washington. Rosenberg shared his cases and expertise with me and several. In the first study, choi et al compared the mri findings of 18 patients with lowgrade chondrosarcoma and 16 patients with enchondroma, patients with lowgrade chondrosarcoma, and reported significantly higher incidence of mri findings p enchondroma from lowgrade chondrosarcoma is problematic, as they can have similar appearances.
Enchondromas are benign cartilaginous growths of the medullary cavity. Enchondroma is a solitary, benign, intramedullary cartilaginous tumour occurring most commonly in small bones of hands and feet. In most cases, enchondromas are painless and do not result in any adverse physical symptoms. Enchondroma health encyclopedia university of rochester. A rare occurrence of enchondroma in neck of femur in an adult. Radiology cases quiz consisting of 10 radiology spotters.
Enchondroma vs low grade chondrosarcoma dr henry knipe and assoc prof frank gaillard et al. Evidence of a lesion on a radiologic study is not definitive enough to make the. Proper usage and audio pronunciation of the word enchondroma. Enchondroma protuberans has been defined as an exophytic enchondroma of a long bone. An enchondroma is a type of noncancerous bone tumor that begins in cartilage. Enchondroma is the name given to a type of a noncancerous growth or tumor which develops in the cartilage within the bones. The judicious use of computed tomography, magnetic resonance imaging, and nuclear medicine in conjunction with appropriate clinical data allows the radiologist.
To determine the validity of clinical and radiological features of enchondroma and low grade chondrosarcoma, and contrast the biopsy results with the clinical diagnosis based on the history and imaging. Cartilage is the connective tissue from which most bones develop. The sections show spaced small cells in a pale matrix with a lightblue tinge. In selected bones such as those of the digits of the hand or feet it may weaken the bone and predispose it to fracture. Enchondromas, also known as chondromas 7, are relatively common intramedullary cartilage neoplasms with benign imaging features. They are encountered frequently in routine clinical practice. There are many different types of cartilage in the body. Enchondromatosis, also known as ollier disease see terminology section, is a nonhereditary, sporadic, skeletal disorder characterized by multiple enchondromas principally located in the metaphyseal regions.
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