PMC5447900_01
A 12-year-old boy with a solitary osteochondroma. Plain radiographs show a small lesion protruding from the bone, mimicking a bone spur at the proximal tibia (a) (left: antero-posterior view, right: lateral view). CT shows that the lesion is located at the medial posterior edge of the tibia (b) (top: axial view, bottom: coronal view). MRI shows continuity of bone marrow with the lesion (c) (top: T1 weighted image, middle: T2 weighted image, bottom: T2 weighted image with fat-suppression). 3-dimensional reconstruction using CT depicts the lesion (d: top). A photograph of a resected specimen (d: bottom). (Yellow arrows indicate the tip of the osteochondroma).
TOORTHJ-11-397_F1.jpg
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F1
The size of the lesion was 0.8 cm on a plain radiograph (Fig. 1a). CT depicted a protuberant bone lesion with continuity to normal bone (Fig. 1b), but an overlying cartilaginous cap was not obvious. There was no obvious inflammation characterized by high signal intensity on a T2 weighted fat-suppression image around the tip of the osteochondroma (Fig. 1c). For surgical resection, the lesions were approached posterior to the conjoint tendon (Fig. 1d).
PMC5447900_02
A 13-year-old girl with a solitary osteochondroma. Plain radiographs show a lesion protruding from the proximal tibia (a) (left: antero-posterior view, right: lateral view). MRI shows continuity of bone marrow with the lesion in axial (b) (top: T1 weighted image, middle: T2 weighted image, bottom: T2 weighted image with fat-suppression) and coronal section (c). A photograph of a resected specimen (d). (Yellow arrows indicate the tip of the osteochondroma).
TOORTHJ-11-397_F2.jpg
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F2
Plain radiographs showed a lesion protruding from the bone with continuity to the underlying bone (Fig. 2a). However, an overlying cartilaginous cap or surrounding inflammation was not apparent (Figs. 2b, c). Surgically, the lesions were approached posterior to the conjoint tendon, and resected using a curved chisel (Fig. 2d).
PMC5447900_03
A 13-year-old girl with a small solitary osteochondroma. Plain radiographs show a small osseous lesion on the proximal tibia (a) (left: antero-posterior view, right: lateral view). CT shows that the lesion is located at the medial-posterior edge of the proximal tibia (b) (top: axial view, bottom: coronal view). A photograph of a resected specimen from the surface (c: top-left) and the bottom (c: top-right). Histologically, a hyaline cartilaginous cap and underlying lamellar bone trabeculae and fatty marrow are seen (c: bottom). (Yellow arrows indicate the tip of the osteochondroma).
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F3
Plain radiographs showed a small 0.5 cm osseous lesion on the antero-posterior radiographic view (Fig. 3a). CT depicted a small protuberant bone lesion with continuity to normal bone (Fig. 3b). The lesion was composed of a hyaline cartilaginous cap and underlying lamellar bone trabeculae and fatty marrow (Fig. 3c).
PMC5447900_04
A 12-year-old girl with hereditary multiple exostoses. Plain radiographs show multiple protruding lesions arising from the distal femur, the proximal tibia and the proximal fibula (a). Radiographs after the lesion at the pes anserinus is resected (b) (left: antero-posterior view, right: lateral view). A photograph of a resected specimen (c: top). Histologically, hyaline cartilagninous cap and underlying lamellar bone trabeculae with fatty marrow are seen (c: bottom). (A yellow arrow indicates the tip of the osteochondroma causing the pain).
TOORTHJ-11-397_F4.jpg
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F4
The plain radiographic findings permitted a diagnosis of multiple hereditary exostoses (Figs. 4a, b). The lesion was composed of a hyaline cartilage cap and underlying lamellar bone trabeculae with fatty marrow (Fig. 4c).
PMC5447900_05
A 15-year-old girl with hereditary multiple exostoses. Plain radiographs show multiple protruding lesions arising from the distal femur, the proximal tibia and the proximal fibula (left: antero-posterior view, right: lateral view). (A yellow arrow indicates the tip of the osteochondroma causing the pain).
TOORTHJ-11-397_F5.jpg
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F5
Plain radiographs showed a bony protruding lesion on the distal femur and proximal fibula and tibia (Fig. 5).