Presentation
Recurrent trauma. To exclude acute bone injury.Incidental finding.
Patient Data
There are no acute fractures, dislocations or subluxations of the right foot in view of recurrent trauma.
Evidence of previous trauma and healed right 5th metatarsal neck and shaft fracture.
Incidental exostosis involving the medial cortex of the terminal phalanx of the right 1st digit, os-naviculare and calcified vascular plaque.
Case Discussion
Features suggest a turret exostosis of the right 1st digit, terminal phalanx, and medial cortex due to the typical benign dome-shaped appearance and medullary continuation on plain film.
The broad differentials include a bizarre parosteal osteochrondromatous proliferation (BPOP) otherwise known as Nora's lesion. These lesions are often in younger patients and do not demonstrate medullary involvement.
A subungual exostosis is a benign osteocartilaginous tumor, the epicenter of which is usually the nailbed as its name implies. They occur in younger patients with a positive traumatic or infective history. The lesion may not easily demonstrate cortical or medullary continuity.
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