How would you describe the mineralization pattern within this mass?
Rings and arcs calcifications
How many osteochondromas can you count?
5, but 6 if you include the one that likely led to the pelvic mass.
What bovine sign is used to describe the appearance of a femoral neck that is enlarged by a sessile osteochondroma(s)?
Brahman bull sign. This breed of a bull has a large, thick neck, similar to the right femoral neck in this patient.
What are the six complications associated with osteochondromas?
1. Malignant degeneration 2. Fracture 3. Neural impingement 4. Vascular impingement 5. Adventitial bursa formation 6. Cosmetic deformity
There is a large mass within the pelvic outlet which demonstrates a fine ring and arc pattern of calcification. The mass occupies the majority of the diameter of the pelvic basin.
On the pelvic outlet projection, the mass appears to arise from the posterior aspect of the right pubic ramus as the cortex is indistinct in this region, although this site of origin is unclear in the current study.
Note that there are multiple sessile osseous excrescences along the proximal right femur including the proximal right femoral neck (Brahman bull appearance) and metaphysis, as well as pedunculated excrescences at the lesser trochanter and femoral neck on the left, and anterolateral ilium on the right. These excrescences demonstrate medullary continuity with their parent site.