Presentation
Swelling on medial side of left thigh just above the knee increasing in size over last few years.
Patient Data
X-ray knee joint frontal and lateral projections showing skeletally immature bones. A rounded bony lesion connected with medial aspect of lower femoral metaphysis through a bony stalk having continuity with both medullary and cortical bone of the femur. It is growing away from the knee joint and uplifting adjacent muscle as evident on AP view. No cortical break, irregularity or lytic lesion is appreciated. There is no fracture. Findings are suggestive of pedunculated osteochondroma.
Case Discussion
Osteochondromas are benign bony lesions that have associated cartilaginous caps.
It has the potential for malignant transformation. Any growth after skeletal maturity, new-onset non-traumatic pain, fracture, lytic lesions or cortical irregularity warn investigation with MRI to rule out malignant transformation.
In this case, its size is increasing before skeletal maturity without any other sign of malignant transformation, so no further MRI imaging is needed.
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