Enchondroma with pathologic fracture
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Sudden onset pain of medial left hand after direct trauma.
A high PD fs/T2 signal medullary cavity lesion with a narrow zone of transition that expands the neck and diaphysis of the fifth metacarpal
Marked cortical thinning
Local cortical breakthrough and dorsal angulation along with neck and distal diaphysis
A few intralesional low signal foci due to chondroid matrix
Soft tissue edematous changes surrounded the fifth metacarpal.
The majority of enchondromas remain asymptomatic and require no treatment. Pathologic fractures are commonly treated by curettage and bone grafting, with follow-up x-rays to monitor for healing and recurrence. An incisional biopsy is obtained intraoperatively. Recurrence is reported in 2-15% and suggests malignancy1.