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Enchondroma with pathological fracture

Case contributed by Matt Skalski
Diagnosis almost certain

Presentation

Hand pain and swelling after a trivial trauma.

Patient Data

Age: 30 years
Gender: Female

A well marginated lucent lesion is observed in the distal metaphysis of the 5th metacarpal. This lesion demonstrates central areas of punctate (popcorn) calcification and mild cortical thinning. An obliquely oriented lucent fracture line is observed extending through the lesion with minimal cortical offset (<2mm). 

Case Discussion

The appearance and location of this lesion is classic for an enchondroma. Pathological fractures are a fairly common presenting feature for these primary benign bone tumors, which are otherwise an incidental finding most often. 

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