Diagnosis and Modality:
- Frontal radiograph of the right shoulder shows a broad-based exostosis with continuity of bone cortex and medullary marrow to the metaphysis of the humerus.
This is a classic radiographic appearance of ‘sessile osteochondroma’ at the most common location (metaphysis) of bone.
Facts:
- Due to aberrant epiphyseal development
- Most common benign bone tumor
- Growth stops after skeletal maturation
- Malignant transformation in 1-2% of solitary lesion
Points:
- 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
Case submitted by: Dr. Rathachai Kaewlai
