PMC4898171_01
10-year-old girl with recurrence of chondroblastoma. MRI of the right hip. (A) Coronal STIR (TR 5250/TE 55/TI 150) and (B) coronal T1 (TR 516/TE 12) weighted MR images of the right hip. Hypointense STIR and T1 lesion (arrow) within the greater trochanter surrounded by inflammatory changes in the adjacent bone and soft tissues.
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T1 and STIR sequences, with edema in the adjacent bone and soft tissues (Fig. 1). The patient was then referred to our institution for evaluation and treatment.
10-year-old girl with recurrence of chondroblastoma. Right hip radiograph. Frontal view of the right hip reveals a well-circumscribed lytic lesion (arrow) in the greater trochanter.
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Re-interpretation of hip radiographs from the outside institution revealed a well-defined lytic lesion within the greater trochanter (Fig. 2).
10-year-old girl with recurrence of chondroblastoma. MRI of the right hip. (A) Axial fat-saturated T2 (TR 4000/TE 81), (B) axial T1 (TR 550/TE 513), and (C) axial postgadolinium fat-saturated T1 (TR 500/TE 13) MR images of the right hip. Relatively hypointense T2 and T1 lesion (arrows) in the soft tissues posteromedial to the greater trochanter, with an associated joint effusion and inflammatory changes in the soft tissues and bone.
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MRI of the hip showed a small joint effusion, with edema in the femoral head and surrounding soft tissues (Fig. 3).
10-year-old girl with recurrence of chondroblastoma. CT of the right hip obtained in conjunction with biopsy, depicted on the bone window. Soft-tissue mass posteromedial to the greater trochanter surrounded by a thin interrupted rim of calcification (arrows).
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A soft-tissue mass surrounded by a thin rim of interrupted periostium posteromedial to the greater trochanter (Fig. 4) went undetected.
10-year-old girl with recurrence of chondroblastoma. MRI of the right hip. (A) Axial fat-saturated T2 (TR 4000/TE 89), (B) coronal T1 (TR 650/TE 13), and (C) axial postgadolinium fat-saturated T1 (TR 566/TE 13) MR images of the right hip. Enlarging relatively hypointense T2 and T1 lesion (arrows) in the soft tissues posteromedial to the greater trochanter, with an associated joint effusion and inflammatory changes in the soft tissues and bone. Postgadolinium, the lesion demonstrates enhancement that is less intense than the surrounding inflammatory changes in soft tissues and bone.
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Embedded in this inflammatory edematous reaction was an oval, 3-cm mass posteromedial to the greater trochanter that enhanced less than the surrounding tissue and therefore was visible as an island of relatively low signal (Fig. 5).
10-year-old girl with recurrence of chondroblastoma. Blue-to-pink chondroid matrix (arrows) on a background of diffuse proliferation of mononuclear cells and focal giant cells (curved arrows) (100x).
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It was composed of a diffuse proliferation of mononuclear cells with intermixed multinuclear giant cells and scattered foci of chondroid matrix, some of which had undergone calcification (Fig. 6).