Post traumatic exostosis

Case contributed by Essam G Ghonaim
Diagnosis almost certain

Presentation

Hard painless non-tender swelling at left ischeal region. Patient reported an old trauma to this region 20 years earlier.

Patient Data

Age: 45 years
Gender: Male
x-ray

An expanding lesion is seen involving left ischium and adjacent portion of corresponding inferior pubic ramus. No apparent cortical breakthrough depicted.

ct

An expanding lesion is seen involving and projecting from left ischium. This lesion shares same cortex and medulla with original bone. No apparent cortical break through. 

Small sclerotic lesion (bone island) is incidentally noted within left femoral neck.

mri

The lesion exhibits intermediate signal that is identical to host bone. MRI also confirms continuity of medulla and cortex between lesion and host bone.

Small low-signal lesion (bone island) is seen within left femoral neck.

MDP dynamic bone scan

Nuclear medicine

No pathological foci seen.

Case Discussion

This case was pathologically proved by CT-guided true-cut biopsy.

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