Chondroblastoma - midfoot

Case contributed by Yasser Asiri
Diagnosis almost certain

Presentation

Left foot pain.

Patient Data

Age: 15 years
Gender: Female
x-ray
Oblique
Oblique
Frontal
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Info

Subtle lucency and cortical ill-definition of the left intermediate cuneiform bone is noted as compared to the right intermediate cuneiform bone.

mri
This study is a stack
Sagittal
STIR
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Long
axis T1
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Long axis
T2 fat sat
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Short
axis T1
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Short axis
PD fat sat
This study is a stack
Short axis
T1 fat sat
This study is a stack
Short axis T1
C+ fat sat
This study is a stack
Sagittal T1
C+ fat sat
This study is a stack
Long axis T1
C+ fat sat
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Info

There is a lesion of isointense signal intensity to the muscle on T1 and of intermediate high signal intensity on T2 images occupying whole of the intermediate cuneiform bone and demonstrates enhancement post contrast administration. There are oedematous changes of the adjacent cuneiform bones. Considering the patient's age and presentation, the most likely diagnosis is chondroblastoma.

Case Discussion

This case shows a rare presentation of chondroblastoma in the intermediate cuneiform bone. Chondroblastoma is one of the differential diagnosis of bone lesions that involve the epiphysis and the epiphyseal-equivalent region in a skeletally immature patient. The tumour is usually painful and on imaging classically demonstrates surrounding oedema and enhancement. The patient underwent surgical resection and bone grafting. The diagnosis was confirmed by the histopathology report. 

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