Case presentation

Dr.Anupkumar Agrawal

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Case

A 16 yr old male presentated with swelling over little finger of right hand No h/o pain

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There is e/o lytic /expansile geographic area of radiolucency at diaphysiometaphysial region of 5th metacarpal of right hand and similar lesion at middle phalanx of same digit is cortical thinning 5/16/12 &endosteal

There

Differential diagnosis

most likely diagnosisEnchondroma Other possibilities are Simple bone cyst Aneurysmal bone cyst Fibrous dysplasia Non ossifying fibroma (FCD) Eosinophilic granuloma Giant cell tumor
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Age group10-30yr

ENCHONDROMA

M.C.site phalanges and metacarpals Usually asymptomatic Radiological features are Geographic ,expansile lytic lesion Diaphysial metaphyseal region Centrally placed Stippled or punctate calcification (ring or arc pattern 5/16/12

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enchondroma involving the proximal end of the proximal

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Axial computed tomography image demonstrates a fluffy

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Simple bone cyst

Age group < 20yr (80% cases between 410yr) M.C.site long bone humerus (proximal metaphysis) rare in small bones Clinically silent until pathological fracture occurs Radiological features Expansile ,lytic geographic metaphyseal Truncated cone appearance Calcification is rare
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Aneurysmal bone cyst

Age 5-20 yr M.c.site-long bones-metaphysis Radiological features Eccentric expansile,metaphyseal ,saccular protrusion of bone thin peripheral cortex Blow out appearance or finger in ballon sign Periosteal new bone formation MRI demonstrate a classic fluid fluid 5/16/12

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Fibrous dysplasia

Age 3-15yr Monostotic and polyostotic m.c.bone-ribs,craniofacial &proximal femur Rare in small bone of hand Radiological features Diametaphyseal,geographic expansile lucent lesion Ground glass appearance Thick sclerotic margin (rind)
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Image

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Non ossifying fibroma

age group Fibrous cortical defect-4-8yr Non ossifying fibroma-8-20 yr M.c. bone long bones-around knee joint Diametaphyseal region Rare in small bone of hand&feet Radiological features Eccentric,expansile ,flame shaped Thinning of cortex,endosteal scalloping
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Eosinophilic granuloma

Age group <20yr M.c. bone skull (axial skeleton) Rarely small bone of hand Radiological features Solitary Geographic expansile lytic ,round to oval Endosteal scalloping ,cortical thinning Sharply demarcated borders Hole within hole appearance(beveling of edges) 5/16/12

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Lateral

skull radiograph in a 30-year-old woman with

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Giant cell tumor

Age group -20-40yr M.c.site long bones-distal femur Rare in small bones of hand Metaphyseal-epiphyseal Begins in metaphysis and then extends to subarticular location Radiological features Eccentric,expansile ,geographic lytic Cortical thinning and wide zone of transition Soap bubble appearance(heavy
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