Presentation
Lump over distal forearm. Thinks it's been there for a long time, but might have got bigger recently. Hard and non-tender.
Patient Data
The distal forearm lump represents a raised cortical surface and overlying cartilage. Appearances are of an osteochondroma.
The x-ray confirms the expanded distal ulna and a moderately sized sessile osteochondroma. It extends dorsally on the lateral view. There is radial extension on the AP view with associated bowing of the radius and sclerosis at the site of developing pseudarthrosis.
Case Discussion
The first mode of investigation for a lump (especially in a pediatric patient) should be an ultrasound. In this case, the diagnosis was made on the ultrasound, but an X-ray allows a clearer picture of the extent of the osteochondroma.
Measuring the cartilage cap on the osteochondroma is important, especially where the patient describes pain because of the relationship between the thickness of the cartilage cap and malignant transformation. In children, it is exceptionally rare.
Unable to process the form. Check for errors and try again.