eMedicine Specialties > Radiology > Musculoskeletal

Enchondroma and Enchondromatosis: Multimedia

Author: Felix S Chew, MD, MBA, EdM, Professor, Department of Radiology, Vice Chairman for Radiology Informatics, Section Head of Musculoskeletal Radiology, University of Washington
Coauthor(s): T Catherine Maldjian, MD, Associate Professor, Department of Radiology, New York Medical College; Director, Radiology Research Center; Chief, Musculoskeletal Radiology, Westchester Medical Center
Contributor Information and Disclosures

Updated: Jul 20, 2009

Multimedia

(Enlarge Image)

Media file 1: Frontal radiograph of the right hand demonstrates a lytic expansile lesion in the fifth metacarpal bone, with thinning of the cortex that has a somewhat scalloped appearance. A pathologic fracture is noted, but no appreciable calcifications are seen in the lesion.

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Frontal radiograph of the right hand demonstrates a lytic expansile lesion in the fifth metacarpal bone, with thinning of the cortex that has a somewhat scalloped appearance. A pathologic fracture is noted, but no appreciable calcifications are seen in the lesion.

(Enlarge Image)

Media file 2: Detail of a lytic expansile lesion in the fifth metacarpal bone in the right hand (same patient as in Image 1 in Multimedia). There is thinning of the cortex with a somewhat scalloped appearance. A pathologic fracture is noted, but no appreciable calcifications are seen in the lesion.

[ CLOSE WINDOW ]

Detail of a lytic expansile lesion in the fifth metacarpal bone in the right hand (same patient as in Image 1 in Multimedia). There is thinning of the cortex with a somewhat scalloped appearance. A pathologic fracture is noted, but no appreciable calcifications are seen in the lesion.

(Enlarge Image)

Media file 3: Frontal radiograph of the left hand demonstrates an expansile lytic lesion in the proximal phalanx of the fifth digit with a distinct zone of transition, thinning of the cortex, and a pathologic fracture. The lesion involves the diaphysis and approaches the end of the bone near the metacarpophalangeal joint. This finding is not uncommon in enchondromas of the small bones. Note the fuzzy calcifications in the matrix of the lesion.

[ CLOSE WINDOW ]

Frontal radiograph of the left hand demonstrates an expansile lytic lesion in the proximal phalanx of the fifth digit with a distinct zone of transition, thinning of the cortex, and a pathologic fracture. The lesion involves the diaphysis and approaches the end of the bone near the metacarpophalangeal joint. This finding is not uncommon in enchondromas of the small bones. Note the fuzzy calcifications in the matrix of the lesion.

(Enlarge Image)

Media file 4: Detail of an expansile lytic lesion in the proximal phalanx of the fifth digit with a distinct zone of transition, thinning of the cortex, and a pathologic fracture (same patient as in Image 3 in Multimedia).

[ CLOSE WINDOW ]

Detail of an expansile lytic lesion in the proximal phalanx of the fifth digit with a distinct zone of transition, thinning of the cortex, and a pathologic fracture (same patient as in Image 3 in Multimedia).

(Enlarge Image)

Media file 5: Radiograph of the right femur demonstrates a calcified intramedullary lesion in the distal shaft (same patient as in Images 6-7 in Multimedia).

[ CLOSE WINDOW ]

Radiograph of the right femur demonstrates a calcified intramedullary lesion in the distal shaft (same patient as in Images 6-7 in Multimedia).

(Enlarge Image)

Media file 6: Radiograph of the right femur demonstrates a calcified intramedullary lesion in the distal shaft (same patient as in Images 5 and 7 in Multimedia).

[ CLOSE WINDOW ]

Radiograph of the right femur demonstrates a calcified intramedullary lesion in the distal shaft (same patient as in Images 5 and 7 in Multimedia).

(Enlarge Image)

Media file 7: Axial computed tomography image demonstrates a fluffy calcific matrix within the medullary canal of the distal femur (same patient as in Images 5-6 in Multimedia). The surrounding cortex is intact.

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Axial computed tomography image demonstrates a fluffy calcific matrix within the medullary canal of the distal femur (same patient as in Images 5-6 in Multimedia). The surrounding cortex is intact.

(Enlarge Image)

Media file 8: Frontal radiograph of the right thigh demonstrates coarse calcifications in the distal femur (same patient as in Images 9-12 in Multimedia).

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Frontal radiograph of the right thigh demonstrates coarse calcifications in the distal femur (same patient as in Images 9-12 in Multimedia).

(Enlarge Image)

Media file 9: Axial T1-weighted magnetic resonance imaging study shows an intramedullary lesion with low signal intensity and lobular morphology in the distal femur (same patient as in Images 8 and 10-12 in Multimedia). The endosteal aspect of the cortex is not affected.

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Axial T1-weighted magnetic resonance imaging study shows an intramedullary lesion with low signal intensity and lobular morphology in the distal femur (same patient as in Images 8 and 10-12 in Multimedia). The endosteal aspect of the cortex is not affected.

(Enlarge Image)

Media file 10: Coronal T1-weighted magnetic resonance imaging study demonstrates predominantly decreased signal intensity within a lesion in the distal femur (same patient as in Images 8-9 and 11-12 in Multimedia). The lesion has a lobular morphology. No endosteal scalloping is noted.

[ CLOSE WINDOW ]

Coronal T1-weighted magnetic resonance imaging study demonstrates predominantly decreased signal intensity within a lesion in the distal femur (same patient as in Images 8-9 and 11-12 in Multimedia). The lesion has a lobular morphology. No endosteal scalloping is noted.

(Enlarge Image)

Media file 11: Axial T2-weighted magnetic resonance imaging study shows regions of high signal intensity in the lesion (same patient as in Images 8-10 and 12 in Multimedia). No surrounding edema is noted.

[ CLOSE WINDOW ]

Axial T2-weighted magnetic resonance imaging study shows regions of high signal intensity in the lesion (same patient as in Images 8-10 and 12 in Multimedia). No surrounding edema is noted.

(Enlarge Image)

Media file 12: Coronal T2-weighted magnetic resonance imaging study demonstrates small lobulated foci of increased signal intensity separated by a background mesh of decreased signal intensity (same patient as in Images 8-11 in Multimedia). The adjacent cortex is intact.

[ CLOSE WINDOW ]

Coronal T2-weighted magnetic resonance imaging study demonstrates small lobulated foci of increased signal intensity separated by a background mesh of decreased signal intensity (same patient as in Images 8-11 in Multimedia). The adjacent cortex is intact.

(Enlarge Image)

Media file 13: 62-year-old woman with enchondroma involving the proximal end of the proximal phalanx of her middle finger. The lesion has a lobular morphology and punctate calcifications. Because of pain, the lesion was curetted and packed with morselized allograft bone.

[ CLOSE WINDOW ]

62-year-old woman with enchondroma involving the proximal end of the proximal phalanx of her middle finger. The lesion has a lobular morphology and punctate calcifications. Because of pain, the lesion was curetted and packed with morselized allograft bone.

More on Enchondroma and Enchondromatosis

Overview: Enchondroma and Enchondromatosis

Imaging: Enchondroma and Enchondromatosis

Follow-up: Enchondroma and Enchondromatosis

Multimedia: Enchondroma and Enchondromatosis

References

Semenova LA, Bulycheva IV. [Chondromas (enchondroma, periosteal chondroma, enchondromatosis)]. Arkh Patol. Sep-Oct 2007;69(5):45-8. [Medline].
Figl M, Leixnering M. Retrospective review of outcome after surgical treatment of enchondromas in the hand. Arch Orthop Trauma Surg. Jun 2009;129(6):729-34. [Medline].
van der Geest IC, de Valk MH, de Rooy JW, Pruszczynski M, Veth RP, Schreuder HW. Oncological and functional results of cryosurgical therapy of enchondromas and chondrosarcomas grade 1. J Surg Oncol. Nov 1 2008;98(6):421-6. [Medline].
Unni KK. Dahlin's Bone Tumors: General Aspects and Data on 11,087 Cases. 5th ed. Philadelphia, Pa: Lippincott-Raven;1996:25-45.
Katz P, Colbert R, Drolet B. Unilateral mosaic cutaneous vascular lesions, enchondroma, multiple soft tissue chondromas and congenital fibrosarcoma--a variant of Maffucci syndrome?. Pediatr Dermatol. Mar-Apr 2008;25(2):205-9. [Medline].
Sun GH, Myer CM 3rd. Otolaryngologic manifestations of Maffucci's syndrome. Int J Pediatr Otorhinolaryngol. Jul 2009;73(7):1015-8. [Medline].
Springfield DS, Gebhardt MC, McGuire MH. Chondrosarcoma: a review. J Bone Joint Surg [Am]. 1996;78:141-9.
D'Angelo L, Massimi L, Narducci A, Di Rocco C. Ollier disease. Childs Nerv Syst. Jun 2009;25(6):647-53. [Medline].
Ranger A, Szymczak A. The association between intracranial tumours and multiple dyschondroplasia (Ollier's disease or Maffucci's syndrome): do children and adults differ?. J Neurooncol. Jun 9 2009;[Medline].
Moser T, Lin XZ, Bazille G, Fleury M, Dietemann JL, Kremer S. Progressive hemianopsia caused by intracranial enchondroma in Ollier disease. Neurology. Dec 9 2008;71(24):2018. [Medline].
Al Kaissi A, Ganger R, Klaushofer K, Rumpler M, Grill F. Achondroplasia manifesting as enchondromatosis and ossification of the spinal ligaments: a case report. J Med Case Reports. Aug 11 2008;2:263. [Medline].
Feldman F, Van Heertum R, Saxena C, et al. 18FDG-PET applications for cartilage neoplasms. Skeletal Radiol. Jul 2005;34(7):367-74.
Bauer HC, Brosjo O, Kreicbergs A, et al. Low risk of recurrence of enchondroma and low-grade chondrosarcoma in extremities. 80 patients followed for 2-25 years. Acta Orthop Scand. Jun 1995;66(3):283-8. [Medline].
Flemming DJ, Murphey MD. Enchondroma and chondrosarcoma. Semin Musculoskelet Radiol. 2000;4(1):59-71. [Medline].
Healey JH, Lane JM. Chondrosarcoma. Clin Orthop Relat Res. Mar 1986;119-29. [Medline].
Hudson TM, Chew FS, Manaster BJ. Radionuclide bone scanning of medullary chondrosarcoma. AJR Am J Roentgenol. Dec 1982;139(6):1071-6. [Medline].
Jaffe HL, Lichtenstein L. Solitary benign enchondroma of bone. Arch Surg. 1943;46:480-93.
Marco RA, Gitelis S, Brebach GT, Healey JH. Cartilage tumors: evaluation and treatment. J Am Acad Orthop Surg. Sep-Oct 2000;8(5):292-304. [Medline].
McDermott AL, Dutt SN, Chavda SV, Morgan DW. Maffucci''s syndrome: clinical and radiological features of a rare condition. J Laryngol Otol. Oct 2001;115(10):845-7. [Medline].
Murphey MD, Flemming DJ, Boyea SR, et al. Enchondroma versus chondrosarcoma in the appendicular skeleton: differentiating features. Radiographics. Sep-Oct 1998;18(5):1213-37; quiz 1244-5. [Medline].
Peiper M, Zornig C. Chondrosarcoma of the thumb arising from a solitary enchondroma. Arch Orthop Trauma Surg. 1997;116(4):246-8. [Medline].
Robbin MR, Murphey MD. Benign chondroid neoplasms of bone. Semin Musculoskelet Radiol. 2000;4(1):45-58. [Medline].
Wang XL, De Beuckeleer LH, De Schepper AM, Van Marck E. Low-grade chondrosarcoma vs enchondroma: challenges in diagnosis and management. Eur Radiol. 2001;11(6):1054-7. [Medline].
Zwenneke Flach H, Ginai AZ, Wolter Oosterhuis J. Best cases from the AFIP. Maffucci syndrome: radiologic and pathologic findings. Armed Forces Institutes of Pathology. Radiographics. Sep-Oct 2001;21(5):1311-6. [Medline]. [Full Text].

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Keywords

enchondroma, enchondromatosis, chondroma, chondrosarcoma, Ollier's disease, Ollier disease, Maffucci syndrome, dystrophic calcifications, benign cartilaginous neoplasms, benign bone neoplasms, osseous neoplasms, pathologic bone fracture, hyaline cartilage rests

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Contributor Information and Disclosures

Author

Felix S Chew, MD, MBA, EdM, Professor, Department of Radiology, Vice Chairman for Radiology Informatics, Section Head of Musculoskeletal Radiology, University of Washington
Felix S Chew, MD, MBA, EdM is a member of the following medical societies: American Roentgen Ray Society, Association of University Radiologists, and Radiological Society of North America
Disclosure: Nothing to disclose.

Coauthor(s)

T Catherine Maldjian, MD, Associate Professor, Department of Radiology, New York Medical College; Director, Radiology Research Center; Chief, Musculoskeletal Radiology, Westchester Medical Center
T Catherine Maldjian, MD is a member of the following medical societies: American Roentgen Ray Society, Association of University Radiologists, International Skeletal Society, Radiological Society of North America, and Society of Skeletal Radiology
Disclosure: Nothing to disclose.

Medical Editor

Michael A Bruno, MD, Associate Professor, Departments of Radiology and Medicine, Pennsylvania State University College of Medicine; Director, Radiology Quality Management Services, Milton S Hershey Medical Center, Pennsylvania State University College of Medicine
Michael A Bruno, MD is a member of the following medical societies: American College of Radiology, American Roentgen Ray Society, Association of University Radiologists, Radiological Society of North America, Society of Nuclear Medicine, and Society of Skeletal Radiology
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

Murali Sundaram, MBBS, FRCR, FACR, Consulting Staff, Department of Diagnostic Radiology, The Cleveland Clinic Foundation
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

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eMedicine Specialties > Radiology > Musculoskeletal

Enchondroma and Enchondromatosis: Multimedia

Multimedia

Frontal radiograph of the right hand demonstrates a lytic expansile lesion in the fifth metacarpal bone, with thinning of the cortex that has a somewhat scalloped appearance. A pathologic fracture is noted, but no appreciable calcifications are seen in the lesion.

Detail of a lytic expansile lesion in the fifth metacarpal bone in the right hand (same patient as in Image 1 in Multimedia). There is thinning of the cortex with a somewhat scalloped appearance. A pathologic fracture is noted, but no appreciable calcifications are seen in the lesion.

Detail of an expansile lytic lesion in the proximal phalanx of the fifth digit with a distinct zone of transition, thinning of the cortex, and a pathologic fracture (same patient as in Image 3 in Multimedia).

Radiograph of the right femur demonstrates a calcified intramedullary lesion in the distal shaft (same patient as in Images 6-7 in Multimedia).

Radiograph of the right femur demonstrates a calcified intramedullary lesion in the distal shaft (same patient as in Images 5 and 7 in Multimedia).

Axial computed tomography image demonstrates a fluffy calcific matrix within the medullary canal of the distal femur (same patient as in Images 5-6 in Multimedia). The surrounding cortex is intact.

Frontal radiograph of the right thigh demonstrates coarse calcifications in the distal femur (same patient as in Images 9-12 in Multimedia).

Axial T1-weighted magnetic resonance imaging study shows an intramedullary lesion with low signal intensity and lobular morphology in the distal femur (same patient as in Images 8 and 10-12 in Multimedia). The endosteal aspect of the cortex is not affected.

Coronal T1-weighted magnetic resonance imaging study demonstrates predominantly decreased signal intensity within a lesion in the distal femur (same patient as in Images 8-9 and 11-12 in Multimedia). The lesion has a lobular morphology. No endosteal scalloping is noted.

Axial T2-weighted magnetic resonance imaging study shows regions of high signal intensity in the lesion (same patient as in Images 8-10 and 12 in Multimedia). No surrounding edema is noted.

Coronal T2-weighted magnetic resonance imaging study demonstrates small lobulated foci of increased signal intensity separated by a background mesh of decreased signal intensity (same patient as in Images 8-11 in Multimedia). The adjacent cortex is intact.

62-year-old woman with enchondroma involving the proximal end of the proximal phalanx of her middle finger. The lesion has a lobular morphology and punctate calcifications. Because of pain, the lesion was curetted and packed with morselized allograft bone.

More on Enchondroma and Enchondromatosis

References

Further Reading

Keywords

Contributor Information and Disclosures

Author

Coauthor(s)

Medical Editor

Pharmacy Editor

Managing Editor

CME Editor

Chief Editor