Learning Radiology xray montage
 
 
 
 
 
Enchondroma


  • Benign cartilaginous tumor

  • Develops in the medullary cavity  

  • Composed of hyaline cartilage  

  • Occurs in 2nd to 3rd decade  

  • Most common site is small bones of the hand  

    • Most common tumor of the hand  

  • Also foot, humerus, femur, tibia and ribs  

  • Hand lesions are usually asymptomatic or associated with pain and swelling  

  • X-ray appearance  

    • Well-defined lytic and slightly expansile lesion (in small bones)  

    • Usually have some internal calcification and endosteal thinning  

    • There may be cortical expansion or thickening  

  • May fracture or, rarely, undergo malignant transformation

    • Growth of lesion or pain should suggest malignant transformation  

  • Multiple enchondromas is called Ollier's disease

    • Nonhereditary

    • May have limb shortening of affected limb

    • Madelung’s deformity of the wrist

    • Enchondromas point toward the joint

      • Exostoses point away from joint

    • Greater incidence of malignant transformation because there are more lesions present (25%)  

  • With cavernous hemangiomas of soft tissues called Maffucci's Syndrome

    • Nonhereditary

    • Multiple hemangiomas usually on extremities (digits)

    • Look for phleboliths in hemangioma

    • Large enchondroma

    • Growth disturbance of affected bones

    • Malignant transformation

      • Greater than solitary enchondroma, less than Ollier’s

      • Hemangioma may become sarcoma in 5% of cases