March 15, 2013

Leg XR, Non-Trauma, Orthopedics, XR

This person presented to the ED with pain in the legs after an acute trauma.  Here are his tibia/fibula views:

Osteochondroma 2Osteochondroma 1

There is no fracture or dislocation.  However, on the proximal fibula you can see a mass…what is that?

This is an example of an osteochondroma.  Osteochondromas are benign tumors of the growth plate that account for roughly 10-15% of all bone tumors.  They are a common incidental finding and occur mostly on the lower extremity.  Less frequently they can be seen on an upper extremity, and uncommonly on the spine.  Osteochondromas very rarely (<1%) transform to malignant lesions.

A great summary of osteochondromas can be found at Radiopaedia.org.  Their plain film appearance is described as:

“An osteochondroma can be either sessile or pedunculated, and is seen in the metaphyseal region typically projecting away from the epiphysis. There is often associated broadening of the metaphysis from which it arises. The cartilage cap is variable in appearance. It may be thin and difficult to identify, or thick with rings and arcs calcification and irregular subchondral bone.

New cortical irregularity or continued growth after skeletal maturity has been reached, as well as frankly aggressive features (e.g. bony destruction, large soft tissue component, metastases) are all worrying for malignant transformation.”

Author:  Russell Jones, M.D.


1.  Niknejad MT, Gaillard F, et al.  Osteochondroma.  http://radiopaedia.org/articles/osteochondroma

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EMREMS: Radiology in Emergency Medicine

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2 Comments on “Osteochondroma”

  1. Radiopaedia.org Says:

    Thanks for citing our content – much appreciated 🙂


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