Multiple hereditary exostoses

Case contributed by Dr Craig Hacking

Presentation

Atraumatic knee pain

Patient Data

Age: 53
Gender: Male
X-ray

Alignment is normal. No fracture identified. No joint effusion. Multiple osteochondromas in keeping with multiple hereditary exostoses. Fusion of the proximal tibiofibular joint. No definite signs of sarcomatous transformation however MRI is indicated given the symptoms of pain after skeletal maturation.

Case Discussion

The features of an osteochondroma that are associated with malignant sarcomatous transformation are GLAD PAST 1:

  • Growth after skeletal maturity
  • Lucency (new)
  • Additional scintigraphic activity
  • Destruction (cortical)
  • Pain after puberty
  • And
  • Soft tissue mass
  • Thickened cartilage cap greater than 1.5cm
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Case information

rID: 37915
Case created: 26th Jun 2015
Last edited: 3rd Sep 2015
Inclusion in quiz mode: Included

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