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