What’s the Diagnosis – Case 113
1
What’s the Diagnosis – Case 113
2
What’s the Diagnosis – Case 113
3
What’s the Diagnosis – Case 113
4
What’s the Diagnosis – Case 113
5
What’s the Diagnosis – Case 113
6
What’s the Diagnosis – Case 113
7
What’s the Diagnosis – Case 113
8
What’s the Diagnosis – Case 113
9
What’s the Diagnosis – Case 113
10
What’s the Diagnosis – Case 113
11
What’s the Diagnosis – Case 113
12
What’s the Diagnosis – Case 113
13
What’s the Diagnosis – Case 113
14
What’s the Diagnosis – Case 113
15
What’s the Diagnosis – Case 113
16
What’s the Diagnosis – Case 113
17
Findings The radiographs demonstrate no abnormality at the lateral plateau and particularly no visualized, abnormal calcification. On the subsequent MRI, there is a well defined mass of the lateral plateau that extends to the end of the bone. The mass is hetereogeneous and contains fluid fluid levels as well as focal areas of markedly low signal likely representing small areas of calcification. There is a prominent amount of surrounding edema in the bone. No periosteal reaction is present and the mass does not extend into the adjacent soft tissue.
What’s the Diagnosis – Case 113
18
What’s the Diagnosis – Case 113
19
What’s the Diagnosis – Case 113
20
What’s the Diagnosis – Case 113
21
Diagnosis: Chondroblastoma Chondroblastoma is an almost always benign mass that occurs in younger patients typically between 10 and 25. It is part of the differential of an end of the bone lesion that includes infection, geode, giant cell tumor, and clear cell chondrosarcoma. The well demarcated nature of this lesion, the areas of probable punctate calcification (which as in this case can be difficult to see on radiographs), the prominent surrounding marrow edema pattern of the bone, and the fluid fluid levels would strongly suggest a chondroblastoma. Fluid fluid levels can be seen in many entities such as ABC, giant cell tumor, fibroosseous lesions, and telangiectatic osteosarcoma and indicate blood/fluid contained spaces. Surgical treatment with curettage and packing is to be performed on this patient.
What’s the Diagnosis – Case 113
22
References Chondroblastoma. Dr Owen Kang and Dr Saqba Farooq et al. Radiopaedia. Chondroblastoma Imaging. Bonnie P Fines, MD; Chief Editor: Felix S Chew, MD, MBA et al. Medscape. May 11, 2015.
What’s the Diagnosis – Case 113
23