Enchondroma with pathological fracture and incidental exostosis

Case contributed by Craig Hacking
Diagnosis almost certain

Presentation

Crush injury to fingers.

Patient Data

Age: 35 years
Gender: Male

Oblique fracture with minor radial translation and dorsal angulation of the 2nd proximal phalanx. The fracture traverses a reasonably well defined rounded eccentrically located 1 cm lucent lesion with a narrow zone of transition and some faint chondroid calcification proximally. Mild endosteal scalloping is present but there is no periosteal reaction. Appearance in keeping with a pathological fracture through an enchondroma.

Small incidental exostosis arising from the dorsolateral cortex of the first metacarpal neck.

Case Discussion

The pathological fracture was treated conservatively with success. There was no follow-up imaging over a considerable amount of time to access any change to the presumed first metatarsal exostosis.

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