OCAD MSK

History

34 year old male with clicking and pain on internal rotation

Figure 1 for case osteochondroma ( RID4136 ) — Figure 1

Figure 2 for case osteochondroma ( RID4136 ) — Figure 2

Figure 3 for case osteochondroma ( RID4136 ) — Figure 3

Figure 4 for case osteochondroma ( RID4136 ) — Figure 4

Figure 5 for case osteochondroma ( RID4136 ) — Figure 5

Discussion

The exostosis has not changed in 3 years. XRs show that it points toward the hip joint, which is odd for an osteochondroma. MRI confirms medullary and cortical continuity and suggests a hyaline cartilage cap, so I believe its a true osteochondroma. Ive not seen one arising from an apophysis (in this case, the lesser trochanter); would we consider this a corollary of Trevors disease? or is that just for intra-articular rather than epiphyseal osteochondroma? This will be resected as it is causing painful friction. Note in slide 4 that it is separate from the iliopsoas insertion and does not represent an old post-traumatic exostosis from previous lesser trochanteric avulsion

Diagnosis

osteochondroma ( RID4136 )

Hilary Umans, MD

Courtesy

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