Enchondromas are benign cartilaginous neoplasms that originate in the medullary canal of tubular bones, believed to result from growth of residual benign cartilage rests displaced from the physis. An enchondroma most often affects the cartilage that lines the inside of the bones. Distinction between enchondroma e and lowgrade chondrosarcoma lgc remains a challenge for any specialist on musculoskeletal sarcomas management including orthopaedic surgeons, pathologists, and radiologists table 1. The lesion margin is partially sclerotic and partially. Podiatrist philadelphia 3801 market street philadelphia, pa 19104 2156629563. Ct scans and mri can also help in diagnosing enchondromas. Pathology pathol a benign cartilaginous tumour, most commonly in the bones of the hands or feet c19. Enchondromas usually reside within the medullary canal of the bone and do not grow. This article provides an overview of the principles of mr imaging and details of its use for diagnosis in the practice of otology. They usually grow slowly and develop in the sinuses and the bones of the skull. Enchondroma versus chondrosarcoma in long bones of. If a doctor suspects that an enchondroma is responsible for a bone fracture or deformity, he or she will usually take xrays, magnetic resonance imaging scans, or other imaging tests to confirm a diagnosis. Large nonaggressive intramedullary lesion of the distal femur shaft with osseous t1hyperintense and. An enchondroma is a benign cartilaginous tumor that arises from the medullary space of the bone.
A ct scan at the level of the fibular head shows a welldefined lytic lesion with a narrow zone of transition. Mri is requested for further assessment after xray. Mri protocols, mri planning, mri techniques and anatomy. This is a classic appearance of an enchondroma in a phalanx on radiographs. Because they are painless, most enchondromas are discovered when xrays are taken for another reason. Focal regions of signal drop out corresponding to calcifications seen on xrays. An enchondroma is a type of noncancerous bone tumor that begins in cartilage. They typically occur in the metaphysis or metadiaphyseal junction of the proximal humerus, proximal and distal femur, and proximal tibia, as in our case.
Enchondromas are small benign tumors made up of cartilage that form in the bone beneath the toenail. Cartilage in the cap has high signal intensity on t2weighted, spinecho mri scans. Large nonaggressive intramedullary lesion of the distal femur shaft with osseous t1hyperintense and chondral t2hyperintense components. Enchondromas are benign lesions made up of hyaline cartilage that arise within medullary bone. Typical mri apperance of a partly ossified enchondroma. Enchondromas are the second most common benign tumor of bones after osteochondroma and most common benign tumor of small tubular bones, as seen here in the fourth proximal.
They are often incidental findings, occurring in just under 2% of the population based on autopsy series. Part 2, t1weighted imagingbased differential diagnosis christopher j. Mri protocols are a combination of various mri sequences, designed to optimally assess a particular region of the body andor pathological process. It may remain in the interior or substance of a cartilage or bone true chondroma, or enchondroma, or may develop on the surface of a cartilage and project under the periosteum of a bone ecchondroma, or ecchondrosis. Enchondroma frontal radiograph of the right hand reveals a lytic lesion in the fourth proximal phalanx yellow arrow with subtle areas of calcified matrix within the lesion compatible with an. Rings and arcs pattern of the chondral components on t2weighted and contrastenhanced t1weighted images. When mri or xray results reveal an enchondroma, the physician will decide on the best treatment measures based on the size, location, and. Jefferson mri protocols jefferson ct protocols jefferson. Each picture or slice shows only a few layers of body tissue at a time. Diagnostic radiologymusculoskeletal imagingtumors basic. The panorama hfo is used with the st sense wrist coil. Enchondroma distal femur what doctors want you to know. The book does a good job of describing the physical principles of mri in a clear and concise manner. This site provides clear and easily accessible guide to many of the practical aspects of mri including mri protocols, mri planning, mri anatomy, mri.
There are various kinds of cartilage in the body and an enchondroma usually affects the cartilage lining the inside of the bones. To determine the validity of clinical and radiological features of enchondroma and low grade chondrosarcoma, and contrast the biopsy results with the clinical diagnosis based on the history and imaging. A welldefined, slightly expansile, lytic lesion is seen in the proximal phalanx white circle through which the fracture has occurred. There is no surrounding lucency, cortical destruction, periosteal reaction or soft tissue mass.
The patients mri, illustrated below, revealed a lesion in the proximal phalanx of the left fifth finger which was confirmed as an enchondroma by subsequent surgery. Enchondromas are the most common benign cystic lesion to involve the phalanges, but they can appear in any bone formed from cartilage. Know the causes, symptoms, treatment and prognosis of enchondroma. Enchondroma, solitary benign cartilaginous tumour that occurs mostly in the shafts of bones of the hands and feet, usually between adolescence and about age 50. Scans were acquired on a 3 t siemens trio tim mr unit. As they grow, they expand and thin the cortex of the parent bone, producing considerable deformity. An mri does not use radiation xrays and is a noninvasive medical test or examination. Magnetic resonance mr imaging is a useful modality for imaging soft tissue lesions of the temporal bone. As of today two types of cartilage tumors remain a challenge even for the orthopedic oncologist. Osteochondroma definition of osteochondroma by medical. Enchondroma in the proximal phalanx of the fifth digit. The study included 96 patients with cartilage type lesions suggestive of an enchondroma e or an low grade chondrosarcoma lgc according.
Guidelines for basic mri of suspected bone and soft tissue. Chondromas are very rare, benign tumors made of cartilage. The clinical, radiological and cytological triad is important for the correct diagnosis of soft tissue chondroma despite worrying cell atypia. Our literary philosophy is that mri books for clinicians should be written by clinicians. It often affects the tiny long bones of the hands and feet. Enchondroma causes, side effects and treatments at. They can also show up in the small bones of the hands, feet, upper arms, thighs and ribs. Enchondromas are the most common bone tumors of the hands and feet and usually are painless. Only in cases where the tumors are aggressive and begin destroying bone tissue do they require further attention, often surgical removal. Computed tomography scan ct scan computed tomography scan ct or cat scan is a noninvasive diagnostic imaging procedure that uses a combination of special xray equipment and sophisticated computer technology to produce crosssectional images often called slices, both horizontally and vertically, of the body. This characteristic allows measurement of the cap, which is an important consideration in malignant transformation.
This test is done to rule out any problems of the spinal cord and nerves. This is an imaging test that uses xrays and a computer to make horizontal images of the body. It is a benign condition and most of the time does not cause any symptoms and rarely does it require any treatment. Enchondroma medical definition merriamwebster medical.
Hi, i am a 48 yr old woman had xrays done 3 yrs ago have degenerative bone an disks, the first xray showed no bone tumors, had another one done two wks ago with an mri and a enchondroma was found 2. The first five chapters of the book introduce the reader to the basics of mr imaging, including the relaxation concept, mr pulse sequences, and mr imaging parameters and options. An enchondroma can be thought of as an island of cartilage within the bone that never transformed into normal bone. It also provides many details for protocols and imaging parameters for various studies. In this study, we included conservatively treated patients with enchondroma or act, who were under radiologic follow. Enchondromas are benign cartilaginous growths of the medullary cavity. It may also affect other bones such as the femur thighbone, humerus upper arm bone, or tibia one of the two lower leg bones. Grit rademacher, unfall krankenhaus berlin ukb, germany 14 fieldstrength issue 44 summer 2011. From the weekend warrior to the pro athlete book with cmesacme credit. There is a nondisplaced fracture through the base of the proximal phalanx of the 4th toe white arrow. If they form in the marrow cavity of bones, they are called enchondromas. This 33yearold man presented to clinic with left shoulder pain of two months duration, radiating to his fingertips. It outlines all sequences and protocols currently applied in our mri section. Mri is the method of choice in the evaluation of this rare clinical entity.
The tumor can involve large portions of the bones, causing thinning of the cortex. Guidelines for basic mri of suspected bone and soft tissue tumours the scandinavian sarcoma group 2012 it is recommended that imaging of suspected tumours should be done on a highfield system minimum 1. The mri machine uses a large magnet and a computer to take pictures of the inside of your body. Chondroma symptoms and treatments aurora health care. Usually asymptomatic or pain due to pathologic fracture age 20 49 years, no gender preference may be due to displaced growth plate sites. Enchondroma is the name given to a type of a noncancerous growth or tumor which develops in the cartilage within the bones. The other common side are proximal tibia and proximal fibula. Plain film radiographs and a mr examination revealed a focal lesion in his left humeral metaphysis which was found to represent an enchondroma. All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. Lateral xray ap xray clinical case report chondrosarcoma in middle finger contributed by dr. The following sequences are recommended as a minimum. The differential is significantly affected by the modality in question, and most entities below can be excluded with mri.
An anteroposterior radiograph of the knee shows a vague area of radiolucency in the proximal fibular head with punctuate internal mineralization. Additional sequences should be done according to local preferences. Enchondroma, ask a doctor about diagnosis, treatment and. Even in the most expert hands, these two entities can lead to a wrong diagnosis and, as a consequence, to. Magnetic resonance imaging mri is useful for assessing continuity of the parent bone with the cortical and medullary bone in an osteochondroma. In selected bones such as those of the digits of the hand or feet it may weaken the bone and predispose it to fracture. Enchondroma definition of enchondroma by the free dictionary. Incidental enchondroma of the femur is seen in 3% of the routine mr knee examination 10 times higher than autopsy series.
An enchondroma is a type of noncancerous bone tumor that develops in cartilage cartilage is the gristly connective tissue from which most bones develop. Ap and lateral conventional radiographs demonstrate a 33x16mm subtle collection of disorganised punctate calcification in the medullary bone of the left distal femoral metadiaphysis. A whole lot, as cofounder jamie heywood explains in this video. This test uses large magnets, radio waves, and a computer to make detailed images of organs and structures in the body. Six centimeters lesion of the proximal humerus with lobulated contours and very high signal intensity on t2weighted images with fat suppression. Mri handbook mr physics, patient positioning, and protocols. It should serve as a useful reference for those who wish to look up various features of protocols or patient positioning for mri studies. The incidence of higher prevalence of enchondroma on imaging as compared to autopsy series is due to increase sensitivity of mri. Continual hardware and software innovations in computed tomography and magnetic resonance imaging are leading to early and better diagnosis and thus. Approximately half of all enchondromas occur in the tubular bones of. The lesion is welldefined with normal marrow fat interposed between the cartilaginous lobules.
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