Presentation
Patient presents with a bony protuberance for investigation.
Patient Data
Incidental finding of hereditary multiple exostoses of bilateral knees.
There is some symmetry and a combination of sessile and pedunculated Osteochrondromata in this young child.
There are sessile right medial femoral metadiaphyseal and left lateral femoral metadiaphyseal osteochrondromas.
Possible tiny focal osteochrondromas right lateral femoral metaphysis and left medial femoral metaphysis.
There are symmetric medial tibial metaphyseal pedunculated osteochondromas.
There is a suspected left proximal fibula metaphyseal sessile osteochondroma.
There is a right proximal fibula metadiaphyseal pedunculated osteochondroma on lateral view.
Incidental suprapatellar bursitis bilaterally.
Case Discussion
Multiple somewhat symmetric sessile and pedunculated osteochondromas in this young child likely consistent with incidental Hereditary Multiple Exostoses (also known as diaphyseal aclasis or osteochrondromatosis).
In this case, they are typically in the most common sites, specifically the distal femur and proximal tibia including the fibula.
They are metaphyseal or metadiaphyseal, pointing away from the epiphyses bilaterally.