Presentation
Right hip pain
Patient Data
Sclerotic bony lesion is noted related to the right iliac bone.
A pedunculated bone lesion is seen originating from the right iliac bone with internal sclerosis, regular outline and thin cortex. It is measuring approximately 2.9 x 3.3 x 7 cm in dimensions.
Mild marrow sclerosis at the posterior aspect of the right iliac bone adjacent to sacroiliac joint.
The lesion shows sclerotic matrix and a thin cartilaginous cap with a maximum thickness of 3 mm. No associated soft tissue mass or surrounding reaction. No bone marrow edema.
The osteolytic lesion noted on CT shows high T2 signal and complete suppression on T2 fat sat sequence, consistent with intraosseous lipoma.
Case Discussion
Radiological features of the lesion are consistent with a giant osteochondroma of the right iliac bone with no signs of malignant transformation. Osteochondroma can be symptomatic, especially if large by its mass effect, and can cause nerve compression and reactive myositis. Though, ongoing pain after skeletal maturity is suspicious for malignant degeneration.