The presentation is a brief overview of the condition however its uncommon variants are not included. Osteochondromas often develop near the growth plate of a bone during childhood. It constitutes 20%50% of all benign bone tumors and 10%15% of all bone tumors. Complete excision of osteochondroma is usually curative. Cardiac radiology genitourinary radiology learning radiology. A bone development abnormality characterized by the development of a benign bone tumor that occurs on the ends of long bones. Osteochondroma of the mandibular condyle temporomandibular. Moreover, costal osteochondroma arising at the costovertebral junction with neural foraminal extension and. To discuss added value of forensic radiology in a disaster victim identification process.
Other secondary deformities such as bowing of the forearm and varus or valgus angulation should be looked for. Chapter 83 covers osteochondroma, and includes information on definition, demographics, clinical features, anatomy, imaging modalities and features, imaging algorithm, applied physics, differential diagnoses and pitfalls, and a bulleted summary of key points. Because, it seemed to me that most of these books were doing a great job of telling one about diseases, but not how to approach their diagnosis. An osteochondroma is a benign noncancerous tumor on the surface of your bone. The most feared sequelae of an osteochondroma is malignant transformation to a chondrosarcoma, and this occurs between approximately 1% if solitary and sporadic to 525% of the time hereditary osteochondromatous syndromes, such as hereditary multiple exostoses i. Condylar osteochondromas are typically situated on the anteromedial surface of the condylar head. Part of the series in radiology book series sera, volume 20 abstract. Osteochondromas are a relatively common imaging finding, accounting for 1015% of all bone tumors and approximately 35% of all benign bone tumors.
Most often, it affects the long bones in the leg, the pelvis, or the shoulder blade. Imaging of osteochondroma rsna publications online. A case report of osteochondroma with unusual clinical and imaging. Mar 02, 2020 an osteochondroma is a cartilagecovered bony excrescence exostosis that arises from the surface of a bone. There is often associated broadening of the metaphysis from which it arises. So in most cases there is no treatment required except regular monitoring so as to identify any changes or complications.
Osteochondromas, which are the most common bone tumors in children, may be solitary or multiple, and they may arise spontaneously or as a result of previous osseous trauma. Tests for osteochondroma can also identify diseases such as secondary peripheral chondrosarcoma and multiple osteochondromatosis. 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. Welcome to the radiology assistant educational site of the radiological society of the netherlands by robin smithuis md. It has rarely been described in middleaged and elderly patients. Osteochondroma represents the most common bone tumor and is a developmental lesion rather than a true neoplasm. Mr is the best imaging modality for visualizing the effect of the lesion on surrounding structures and for evaluating the hyaline cartilage cap. This process is experimental and the keywords may be updated as the learning algorithm improves. The shape of the proximal femur resembels that of the staff carried by herders shepherds, which is known. Metachondromatosis is a rare disorder that exhibit symptoms of both multiple osteochondromas and enchondromas in. Osteochondroma and osteochondromatosis hereditary multiple. Radcases and aunt minnies atlas and imagingspecific diagnosis here is the list of rest of the radiology casesspotters.
Most multiple osteochondroma patients also suffer from a variety of orthopaedic deformities like shortening of the ulna with secondary bowing of the radius 3960%, inequality of the limbs 1050%,varus or valgus angulation of the knee 833%, deformity of the ankle 254% and disproportionately short stature. A skull base osteochondroma benign exostosis in a 38yearold man is reported. We present a case of a 37yearold patient with preauricular pain and a progressive mandibular deformity secondary to a. Mr or ct imaging can demonstrate cortical and medullary continuity between the osteochondroma and the parent bone as a distinctive feature. It is usually has a hyaline lined cartilaginous cap the cortex and spongiosa of the lesion merge imperceptibly with that of the host bone d.
They are the most common benign bone lesions and present during late childhood and adolescence. The presence of multiple lesions is associated with multiple hereditary exostosis mhe and the ext genes. This book covers typical imaging features of benign and malignant bone tumors in the hip and knee. Osteochondroma, also referred to as osteocartilaginous exostosis or plainly exostosis, is the most common benign bone tumor. Osteochondroma is the most common benign tumor or tumorlike lesion of bone. Cartilage caped exostosis osteocartilaginous exostosis osteochondroma is a bony exostosis projecting from the external surface of a bone it is usually has a hyaline lined cartilaginous cap the cortex and spongiosa of the lesion merge with.
Pathogenesis and aetiology of this tumour have not been well understood. Cooper, md, radiology medical group, san diego, california email protected. Learning mr physics early will help you make the most of your mr rotations if you program relegates you to reading plain films for your first nine months, then nevermind. Plain xrays will show a bony outgrowth, either with a narrow or broad base. No joint effusion or abnormal soft tissue calcifications. Ossification of the posterior longitudinal ligament opll osteitis condensans ilii. Osteochondromas are one of the most common benign bone tumours. Drawing shows an osteochondroma arising from the lateral aspect of the distal femur with a hyaline cartilage cap and overlying bursa. It arises in bones preformed by endochondral ossification and the most common site of involvement is the metaphyseal region of the long. Radiographically, enchondromas appear as geographic, mildly expansile, lytic lesions, which may lead to mild cortical thinning. No treatment is required unless the tumour interferes with function, in which case it should be. Malignant transformation is seen in 1% of solitary osteochondromas and in 3%5 % of patients with hme. They are cartilagecapped bony projections from the external surface of a bone. Osteochondroma is exceptional in the hand and foot, and it does.
Management of the patient with an osteochondroma either as. A cartilaginous matrix rings and arcs is often present, less often in lesions occurring in the hands and feet. The cell of origin of osteochondroma development remains a point of debate among researchers, as research by different groups indicates either a proliferating cell of the growth plate or mesenchymal stem cells of the periochondrium as the cell of origin. Radiology teaching files university of rochester medical. The pathognomonic radiographic feature is that the cortex of the host bone flares into the cortex of the osteochondroma, and the cancellous bone of the osteochondroma blends with the cancellous bone of the metaphysis. Recommended reading for firstyear radiology residents. Symptoms, if any, are determined by the location and size of the tumor.
The system is intended to provide practice to physicians, fellows and residents in the interpreptation of radiological images from a variety of different cases. In adults, the cartilaginous cap regresses and becomes thin due to. The zone of transition is narrow, although it can be lobular. Debate continues as to whether osteochondroma is a developmental disorder pseudotumoral lesion or a neoplasm. The spinal canal is a narrow, compact space containing important structures, and even a relatively small lesion can lead to potentially serious complications.
Recognizing the basics with student consult online access. It usually grows as the child grows and stops when the child reaches skeletal maturity. Learningradiology osteochondroma, tumor, bone, benign. The radiographic appearance of this tumor is often diagnostic and reflects its pathologic characteristics, that is, a lesion composed of cortical and medullary bone with an overlying hyaline cartilage cap. Data on the occurrence of osteochondroma show that the reported incidence of costal osteochondroma is very low. Osteochondroma is the most common benign bone tumor.
In the trunk, more frequently involved are the scapula and ilium. Jun 30, 2011 the cartilaginous cap deserves the most attention when differentiating a benign osteochondroma from a secondary chondrosarcoma that arose from a preexisting osteochondroma. Osteochondromas are cartilagecovered, histologically normal bony projections exostoses on the external surface of a bone in the vicinity of growth plates. Secondary chondrosarcoma from osteochondroma in proximal. In adults, the cartilaginous cap regresses and becomes thin due to enchondral ossification of the majority of the cap.
Radiology books for entrance exams like neetaiims pgi. Specifically, the bone in question belongs to a near complete, fairly well preserved skeleton buried in tomb 82 of calle gallo, a multiple tomb containing the remains of three adult and five immature individuals. To learn about the methods using forensic radiology in a disaster victim identification process. Osteochondroma osteocartilaginous exostosis is a benign cartilage capped bony neoplasm arising on the external surface of bone containing a marrow cavity that is continuous with that of the underlying bone. An osteochondroma can affect any bone preformed in cartilage. A few of these are camera pictures, none the less these are typical cases. The cartilaginous cap deserves the most attention when differentiating a benign osteochondroma from a secondary chondrosarcoma that arose from a preexisting osteochondroma. When the child is fully developed, the osteochondroma also stops growing. The tumor is often diagnosed as an incidental finding. Definition osteochondroma is a bony exostosis projecting from the external surface of a bone. The tumor can occur singly or in multiples and in rare instances the tumors may become malignant. Radcases and aunt minnies atlas and imagingspecific diagnosis. Osteochondroma or osteocartilaginous exostosis is the most common benign tumor of bone.
X ray sessile variant creates a broad based exostosis. There is a pedunculated osteochondroma measuring approximately 3. Here are instructions about radiology cases and spotters. In large, secondary chondrosarcoma arises at the site of osteochondroma due to increased thickness of the cartilage cap indicating potential malignant transformation. An osteochondroma is made up of both bone and cartilage and is the outgrowth of growth plate. Most recommended book by residents who have cleared neet recently. A case report of osteochondroma with unusual clinical and. Osteochondroma is the most common benign bone tumor and the most common skeletal neoplasm.
Radiology museum depicting important events in radiology history like roentgens journey of discovering xrays. Please practice handwashing and social distancing, and check out our resources for adapting to these times. Osteochondromas of the spine are rare and are unique from their counterparts in the long bones and elsewhere. William herrings clear, conversational writing style employs a touch of humor to explain what you need. Osteochondroma is a bony developmental anomaly which forms due to exophytic protuberance on the surface of growing bones. Exophytic lesion of bone surface composed of a stalk of mature bone with a cartilaginous cap. They account for approximately 35% of all benign bone tumors and 9% of all bone tumors. Illustrative cases have been carefully selected from thousands processed at the orthopedic department of beijing jishuitan hospital, which holds a leading position in orthopedics in china. Its peak incidence is in the second decade of life. Radiationinduced bone tumours include osteochondroma and sarcoma, most commonly osteosarcoma. Abnormal outgrowth of bone and cartilage associated with growth plate. Osteochondromas are the most common benign bone tumors and are comprised of a bony prominence with a cartilaginous cap. Osteochondroma pediatric orthopaedic society of north. Diagnostic radiologymusculoskeletal imagingtumors basic.
Osteochondroma is a bony excrescence with welldefined limits, having a thin outer cortex and an internal cancellous structure. Although usually thought of as a benign bone tumor, they may be thought of as a developmental anomaly. It can be easily diagnosed with the help of xrays and mri. Osteochondromas are common and may develop spontaneously following trauma or may have a hereditary basis. General instructions for spotters recommended book for spotters. Multiple osteochondromas hereditary multiple osteocartilaginous exostoses, diaphyseal aclasis epiphyseal osteochondroma dysplasia. The most frequent localization is in the long bones.
After reading this article and taking the test, the reader will be able. Osteochondroma is the most common primary bone tumor comprising more than onethird of all benign bone tumors. A growth plate is cartilage near the ends of long bones, such as the thigh bone. General instructions for spotters the recommended book for spotters. Cartilage caped exostosis osteocartilaginous exostosis osteochondroma is a bony exostosis projecting from the external surface of a bone it is usually has a hyaline lined cartilaginous cap the cortex and spongiosa of the lesion. Osteochondroma journalsomics internationalorthopedic and. There are already plenty of good books out there on introductory musculoskeletal radiology. Osteochondroma is an overgrowth of cartilage and bone that happens at the end of the bone near the growth plate. Radiology cases quiz consisting of 10 radiology spotters. Histologically an osteochondroma consists of a cartilage cap there should be no mitotic cells. Continued lesion growth and a hyaline cartilage cap. Osteochondroma, solitary benign tumour that consists partly of cartilage and partly of bone. Secondary chondrosarcoma from osteochondroma in proximal humerus. This book is an ideal guide for anyone who deals with msk mri on a regular basis, including general radiologists who have not completed a dedicated musculoskeletal radiology fellowship, radiologists who would want to brush up on their msk mri reading and reporting skills.
A case report nf erdem1, m manisali2 abstract introduction osteochondroma is a slowly growing benign tumour that is rarely seen in the maxillofacial region. Osteochondroma is the most common primary bone tumor comprising. Mri was not only very useful for determining the extent of the tumour, but also showed its fat content and, on contrastenhanced fatsuppressed images, its vascularity. No treatment is required unless the tumour interferes with. Join our telegram group and channel for more radiology cases.
An osteochondroma is a cartilagecovered bony excrescence exostosis that arises from the surface of a bone. An osteochondroma can be either sessile or pedunculated and is seen in the metaphyseal region typically projecting away from the epiphysis. They can present with progressive deviation of the mandible to the opposite side with restriction of function. Extensive calcification with radiolucent irregularities of the cap implies possibly malignant change. To appreciate the role of forensic radiology in a disaster victim identification process.
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