Presentation
Atraumatic knee pain
Patient Data
Age: 55 years
Gender: Male
From the case:
Multiple hereditary exostoses
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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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