Accidentally discovered tibial lesion on ankle radiography for trauma.
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A well defined lobulated intramedullary metadiaphyseal lesion occupying the distal tibia and returns low signal on T1, bright signal on T2, STIR and T2* sequences. The T2 gradient sequence augmented the hypointense foci within the lesion which was initially seen on T2/STIR sequences that representing calcification. No infiltration of the bone cortex or extra osseous spread. The marrow signal within the talus and possible fracture line are related to the trauma.
The initial diagnosis for the lesion was enchondroma, however biopsy was obtained for fear of chondrosarcoma which confirmed the benign nature. As the lesion is asymptomatic, it was left for follow up only.