Bizarre parosteal osteochondromatous proliferation (BPOP) - Nora lesion
Presentation
The patient presents with a painful right first toe with associated swelling and a palpable bony lesion. There is negative trauma.
Patient Data
There is a marginated osseous lesion in continuity with the lateral basal cortex of the right 1st digit, terminal phalanx. There is regional soft tissue swelling. There is no periosteal reaction and no occult pathological fracture. Incidental Morton's toes (2nd and 3rd digits).
Case Discussion
Features suggestive of a bizarre parosteal osteochondromatous proliferation (BPOP) otherwise known as a Nora lesion. There is a characteristic lack of medullary involvement or continuity.
The differentials include a turret exostosis (has medullary continuation) and a subungual exostosis (typically subungual with possible cortical and medullary involvement).
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