PMC9381722_01
Preoperative findings on X-ray. Plain radiographs showing the anteroposterior (A) and mediolateral (B) views of the right knee.
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X-ray demonstrated a possible osteochondroma of the proximal right tibia (Figure 1A and B).
Preoperative findings on MRI. MRI showing the sagittal (A) and axial (B) views of the right knee.
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MRI confirmed the diagnosis and revealed that the patellar tendon partially inserted on the osteochondroma as well as the tibial tubercle (Figure 2A and B).
Pre-operative image of large anterior bony prominence just distal to the tibial tubercle of the patient's right knee.
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Given that the mass appeared to be growing in size and the patient was progressively symptomatic, it was decided that surgical excision would be the most appropriate treatment (Figure 3).
Dimensions of the resected mass were 5.0 cm x 4.0 cm x 2.0 cm (A). Hematoxylin and eosin staining of disorganized, woven bone with immature cartilage, and irregular architecture on 4x (B) and 10x magnification (C).
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Dimensions of the resected mass were 5.0 cm x 4.0 cm x 2.0 cm (Figure 4A). Pathology confirmed that the mass was a benign osteochondromatous proliferation, with irregular architecture and immature cartilage giving rise to disorganized woven bone (Figure 4B and C).
Findings on X-ray 2 months postoperatively. X-ray showing the anteroposterior (A) and anteromedial (B) views of the right knee.
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Bracing was discontinued given that the patient was observed to bear weight as tolerated and the radiographs showed no concern for fracture (Figure 5A and B).
Findings on X-ray 19 months postoperatively. X-ray showing the standing hips-to-ankles view (A), left lateral (B), and right lateral (C) views with increased cortical density in the area of anterior resection without recurrence.
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Radiographs demonstrated progressively healing tissue in surgical site evident by remodeling in the area of the lesion inferior to the tibial tubercle (Figure 6A-C).
At 19-month post-operatively, clinical examination showed fully healing of the incision without any recurrence of the anterior mass.
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Clinical examination showed fully healing of the incision without any recurrence of the anterior mass (Figure 7).