Osteochondroma

Case contributed by Adrian Cavender
Diagnosis almost certain

Presentation

The patient presents with pain and a palpable mass on the left lower leg.

Patient Data

Age: 20 years
Gender: Male

Left lower leg

x-ray

X-ray of the left lower leg demonstrates an exophytic osseous lesion of the fibula with origination from the proximal fibular metadiaphysis.

Left tibia fibula

mri

Osseous lesion arising from the proximal fibular metadiaphysis. Heterogenous T2 hyperintensity of a suspected cartilage cap overlying the distal aspect of the osseous lesion. This cartilage cap measures up to 15 mm in the coronal plane but only 5 mm in the axial plane.

Case Discussion

The patient's painless baseline was interrupted by strenuous activity that led to localizable pain on the left calf with a palpable mass medially. As later proven by imaging, though, that mass actually arose laterally from the fibula and extended through the medial calf. Given the developmental nature of these lesions, it is likely that the mass had long been present and was only discovered upon further attention due to pain.

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