Presentation
Pain in joint, hip, pelvis or thigh. History of pain and lump on right medial thigh for 2 months
Patient Data
A pedunculated appearing osteochondroma measuring 2.5 cm in length and 1.5 cm in thickness at the base is seen arising from the medial cortex of the distal femoral metaphysis and demonstrates mild cortical irregularity at its proximal aspect.
A sessile appearing osteochondroma measuring approximately 1 cm in length and 1.6 cm at the base is seen arising from the lateral cortex of the distal femoral metaphysis and demonstrates mild cortical irregularity distally.
No other discrete focal lesion or soft tissue mass in the right femur including the hip and knee. No knee joint effusion.
The alignment at the knee and hip appears normal. The bone density is normal. No abnormal soft tissue calcifications.
Radiographic follow up in 2 to 3 weeks is suggested to rule out an occult injury. Further evaluation with MRI with contrast may be considered if there is persistent pain, palpable soft tissue mass or significant growth at this site.
Case Discussion
Osteochondromas are the most common benign osseous tumour. It is a cartilage-capped bony outgrowth arising from the cortex. They tend to grow out of long bone metaphysis. The most common symptom is painless swelling at its location.
This case was submitted with supervision and input from:
Soni C. Chawla, M.D.
Health Sciences Clinical Professor,
Department of Radiological Sciences,
David Geffen School of Medicine at UCLA.
Attending Paediatric Radiologist,
Olive View - UCLA Medical Centre.
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