PMC8337121_01
X-ray demonstrating the large nidus and the preservation of the proximal epiphysis. The important swelling of the fourth toe is well demonstrated.
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The physis remained intact (Figure 1).
T2-weighted image on MRI, showing the sclerotic nidus hyposignal and the surrounding inflammation of the soft tissues around (hypersignal).
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The MRI showed a hyposignal center of the distal end of the third phalanx of the fourth toe with surrounding inflammatory response and edema (Figure 2).
Gadolinium-enhanced T1-weighted images on MRI, showing the relative avascular nidus surrounded by hypervascular inflamed tissues.
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The injection of gadolinium shows an increase of the signal in T1 around a more avascular center (Figure 3).
Histologic analysis demonstrating the characteristic pink-staining osteoid in a fibrovascular stroma (H&E staining, x300).
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The specimen was sent as such for histologic examination and the diagnosis was confirmed (Figure 4).
(a) X-ray demonstrating the lyophilized bone graft three week after the intervention. (b) X-ray demonstrating the complete incorporation and remodeling of the graft one year after the intervention.
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After one year, the swelling of the toe subsided totally and the patient remained asymptomatic (Figures 5(a) and 5(b)).