Axial T2-weighted MR image shows an exostosis with a bright cartilagenous cap (arrowheads), which is thin and smooth.
- This is a classic radiographic appearance of ‘sessile osteochondroma’ at the most common location (metaphysis) of bone.
- Due to aberrant epiphyseal development
- Most common benign bone tumor
- Growth stops after skeletal maturation
- Malignant transformation in 1-2% of solitary lesion
- Suspect malignant transformation if: growth after skeletal maturation, pain in the absence of fracture, bursitis or nerve compression
- MRI and CT to demonstrate thickness of cartilaginous cap, if >2 cm suspect malignancy
Reference: Stoller et al. Diagnostic Imaging: Orthopedics. 2004
Credit: Image Courtesy of RadiologyinThai.com