Enchondroma with pathologic fracture

Case contributed by Bahman Rasuli
Diagnosis almost certain


Sudden onset pain of medial left hand after direct trauma.

Patient Data

Age: 35 years
Gender: Female

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.

Case Discussion

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.

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