Pathological fracture of enchondroma

Case contributed by Dr Ian Bickle

Presentation

Pain in the right index finger following trivial trauma. Fracture?

Patient Data

Age: 20 years
Gender: Female

Expansile cystic lesion in the base of the index finger metacarpal with a narrow zone of transition. It is predominantly lucent with an internal matrix.

Cortical step and thin radiolucent line on the radial aspect that extends into the lesion.

X-ray

Several months later

A small amount of callus has formed in the interim consistent with a healing fracture of an underling benign bone lesion.

Diagram

From Dr Matt Skalski's case.

Case Discussion

The hand is a common site for enchondromas, many of which are identified incidentally on imaging.

Enchondromas are one of the commoner benign bone lesions.

To be termed a pathological fracture the underlying bone lesion need not be malignant.  It merely indicated an inherent weakness of the bone due to an underlying lesion of an alternative pathology.

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Case information

rID: 62426
Published: 15th Jan 2020
Last edited: 15th Jan 2020
Tag: viva3, crh
Inclusion in quiz mode: Included