Presentation
Swelling and pain of the index finger.
Patient Data
An expansile lytic lesion is seen involving the proximal phalanx of the index finger. The lesion shows internal stippled calcifications. The bony cortex is intact with no destruction or extraosseous soft tissue component.
An expansile bony lesion is seen involving the proximal phalanx of the index finger with an intact hypointense bony cortex. The lesion displays intermediate SI in T1 WIs, and high SI in T2 and proton-density images. The lesion shows islands of signal void calcifications, as well as areas of bony matrix within its substance. The absence of cortical destruction and extraosseous soft tissue component reflects the lesion's benign nature.
Case Discussion
Enchondroma is the most common primary bone tumour of the hand. These lesions are usually seen in the 3rd and 4th decades of life. It usually affects the tubular bones, with the proximal phalanges being the most commonly affected. Enchondroma is usually characterised by lytic nature and internal stippled calcifications. Malignant transformation into chondrosarcoma is suspected in the presence of periosteal reaction, soft tissue invasion and poorly demarcated boundaries. The differentiation between enchondroma and low-grade chondrosarcoma by imaging alone is difficult.
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