Difference between revisions of "Osteochondroma differential diagnosis"

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==Differentiating Osteochondroma from other Diseases==
 
==Differentiating Osteochondroma from other Diseases==
  
*The table below summarizes the findings that differentiate osteochondroma from other conditions that cause bone deformity, bone growth, overlying bursitis, and  mechanical joint problems.<ref name="pmid18853760">{{cite journal |vauthors=Kitsoulis P, Galani V, Stefanaki K, Paraskevas G, Karatzias G, Agnantis NJ, Bai M |title=Osteochondromas: review of the clinical, radiological and pathological features |journal=In Vivo (Athens, Greece) |volume=22 |issue=5 |pages=633–46 |year=2008 |pmid=18853760 |doi= |url=http://iv.iiarjournals.org/cgi/pmidlookup?view=long&pmid=18853760}}</ref>
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*The table below summarizes the findings that differentiate osteochondroma from other conditions that cause bone deformity, bone growth, overlying bursitis, and  mechanical joint problems.<ref name="pmid18853760">{{cite journal |vauthors=Kitsoulis P, Galani V, Stefanaki K, Paraskevas G, Karatzias G, Agnantis NJ, Bai M |title=Osteochondromas: review of the clinical, radiological and pathological features |journal=In Vivo (Athens, Greece) |volume=22 |issue=5 |pages=633–46 |year=2008 |pmid=18853760 |doi= |url=http://iv.iiarjournals.org/cgi/pmidlookup?view=long&pmid=18853760}}</ref><ref>{{cite book | last = Peabody | first = Terrance | title = Orthopaedic oncology : primary and metastatic tumors of the skeletal system | publisher = Springer | location = Cham | year = 2014 | isbn = 9783319073224 }}</ref><ref>{{cite book | last = Czerniak | first = Bogdan | title = Dorfman and Czerniak's bone tumors | publisher = Elsevier/Saunders | location = Philadelphia, PA | year = 2016 | isbn = 9780323023962 }}</ref><ref name="pmid3021775">{{cite journal| author=Frassica FJ, Unni KK, Beabout JW, Sim FH| title=Dedifferentiated chondrosarcoma. A report of the clinicopathological features and treatment of seventy-eight cases. | journal=J Bone Joint Surg Am | year= 1986 | volume= 68 | issue= 8 | pages= 1197-205 | pmid=3021775 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3021775  }} </ref><ref name="pmid9827715">{{cite journal| author=Björnsson J, McLeod RA, Unni KK, Ilstrup DM, Pritchard DJ| title=Primary chondrosarcoma of long bones and limb girdles. | journal=Cancer | year= 1998 | volume= 83 | issue= 10 | pages= 2105-19 | pmid=9827715 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9827715  }} </ref>
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{|
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! align="center" style="background:#4479BA; color: #FFFFFF;" + |Disease
 +
! align="center" style="background:#4479BA; color: #FFFFFF;" + |'''Malignant lesion in patients'''
 +
'''> 40 years'''
 +
! align="center" style="background:#4479BA; color: #FFFFFF;" + |'''chondrogenic Histology'''
 +
! align="center" style="background:#4479BA; color: #FFFFFF;" + | '''Sacral lesions''' in elderly
 +
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Treatment is wide resection alone
 +
|-
 +
! align="center" style="background:#DCDCDC;" + |Chondrosarcoma
 +
| align="center" style="background:#F5F5F5;" + | +
 +
| align="center" style="background:#F5F5F5;" + | +
 +
| align="center" style="background:#F5F5F5;" + | +
 +
| align="center" style="background:#F5F5F5;" + | +
 +
|-
 +
! align="center" style="background:#DCDCDC;" + |[[Metastasis|Metastic disease]]
 +
| align="center" style="background:#F5F5F5;" + | +
 +
| align="center" style="background:#F5F5F5;" + | -
 +
| align="center" style="background:#F5F5F5;" + | +
 +
| align="center" style="background:#F5F5F5;" + | -
 +
|-
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! align="center" style="background:#DCDCDC;" + |[[Lymphoma]]
 +
| align="center" style="background:#F5F5F5;" + | +
 +
| align="center" style="background:#F5F5F5;" + | -
 +
| align="center" style="background:#F5F5F5;" + | +
 +
| align="center" style="background:#F5F5F5;" + | -
 +
|-
 +
! align="center" style="background:#DCDCDC;" + |[[Myeloma]]
 +
| align="center" style="background:#F5F5F5;" + | +
 +
| align="center" style="background:#F5F5F5;" + | -
 +
| align="center" style="background:#F5F5F5;" + | +
 +
| align="center" style="background:#F5F5F5;" + | -
 +
|-
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! align="center" style="background:#DCDCDC;" + |Malignant Fibrous Histiocytoma
 +
| align="center" style="background:#F5F5F5;" + | +
 +
| align="center" style="background:#F5F5F5;" + | -
 +
| align="center" style="background:#F5F5F5;" + | +
 +
| align="center" style="background:#F5F5F5;" + | -
 +
|-
 +
! align="center" style="background:#DCDCDC;" + |Secondary sarcoma
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! align="center" style="background:#F5F5F5;" + | +
 +
! align="center" style="background:#F5F5F5;" + | -
 +
! align="center" style="background:#F5F5F5;" + | -
 +
! align="center" style="background:#F5F5F5;" + | -
 +
|-
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! align="center" style="background:#DCDCDC;" + |[[Enchondroma]]
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! align="center" style="background:#F5F5F5;" + | -
 +
! align="center" style="background:#F5F5F5;" + | +
 +
! align="center" style="background:#F5F5F5;" + | -
 +
! align="center" style="background:#F5F5F5;" + | -
 +
|-
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! align="center" style="background:#DCDCDC;" + |Periosteal [[chondroma]]
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! align="center" style="background:#F5F5F5;" + | -
 +
! align="center" style="background:#F5F5F5;" + | +
 +
! align="center" style="background:#F5F5F5;" + | -
 +
! align="center" style="background:#F5F5F5;" + | -
 +
|-
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! align="center" style="background:#DCDCDC;" + |[[Osteochondroma]]
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! align="center" style="background:#F5F5F5;" + | -
 +
! align="center" style="background:#F5F5F5;" + | +
 +
! align="center" style="background:#F5F5F5;" + | -
 +
! align="center" style="background:#F5F5F5;" + | -
 +
|-
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! align="center" style="background:#DCDCDC;" + |Parosteal [[osteosarcoma]]
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! align="center" style="background:#F5F5F5;" + | -
 +
! align="center" style="background:#F5F5F5;" + | -
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! align="center" style="background:#F5F5F5;" + | -
 +
! align="center" style="background:#F5F5F5;" + | +
 +
|-
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! align="center" style="background:#DCDCDC;" + |[[Adamantinoma]]
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! align="center" style="background:#F5F5F5;" + | -
 +
! align="center" style="background:#F5F5F5;" + | -
 +
! align="center" style="background:#F5F5F5;" + | -
 +
! align="center" style="background:#F5F5F5;" + | +
 +
|-
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! align="center" style="background:#DCDCDC;" + |[[Chordoma]]
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! align="center" style="background:#F5F5F5;" + | -
 +
! align="center" style="background:#F5F5F5;" + | -
 +
! align="center" style="background:#F5F5F5;" + | -
 +
! align="center" style="background:#F5F5F5;" + | +
 +
|-
 +
! align="center" style="background:#DCDCDC;" + |[[Squamous cell carcinoma]]
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! align="center" style="background:#F5F5F5;" + | -
 +
! align="center" style="background:#F5F5F5;" + | -
 +
! align="center" style="background:#F5F5F5;" + | -
 +
! align="center" style="background:#F5F5F5;" + | +
 +
|-
 +
|}
 +
 
  
 
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{| style="border: 0px; font-size: 90%; margin: 3px; width: 1000px" align=center

Latest revision as of 02:24, 13 October 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

Osteochondroma must be differentiated from other diseases that cause bone deformity, bone growth, overlying bursitis, and mechanical joint problems such as enchondroma, chondroblastoma, periosteal chondroma, and chondromyxoid fibroma.[1]

Differentiating Osteochondroma from other Diseases

  • The table below summarizes the findings that differentiate osteochondroma from other conditions that cause bone deformity, bone growth, overlying bursitis, and mechanical joint problems.[1][2][3][4][5]
Disease Malignant lesion in patients

> 40 years

chondrogenic Histology Sacral lesions in elderly Treatment is wide resection alone
Chondrosarcoma + + + +
Metastic disease + - + -
Lymphoma + - + -
Myeloma + - + -
Malignant Fibrous Histiocytoma + - + -
Secondary sarcoma + - - -
Enchondroma - + - -
Periosteal chondroma - + - -
Osteochondroma - + - -
Parosteal osteosarcoma - - - +
Adamantinoma - - - +
Chordoma - - - +
Squamous cell carcinoma - - - +


Differential Diagnosis Similar Features Differentiating Features
Enchondroma
  • Benign cartilaginous neoplasm
  • Usually found in children, enchondromas are asymptomatic
  • These tumors arise from remnants of the growth plate
  • Located in the metaphyseal region
  • Imaging features, such as:
  • Endosteal scalloping
  • Well circumscribed mass
  • Lytic lesions
Chondroblastoma
  • Benign cartilaginous neoplasm
  • Affects young patients
  • Located on long bones
  • They arise in the epiphysis or apophysis of a long bone
  • Classical location is the upper one-third of the tibia
Periosteal chondroma
  • Benign cartilaginous neoplasm
  • Commonly located on the proximal humerus and distal femur
  • Affects young patients
  • Symptomps are usually present for a long period of time
  • Imaging features, include:
  • No stalk or peduncle as in an osteochondroma
Chondromyxoid fibroma
  • Benign cartilaginous neoplasm
  • Located in the metaphyseal region of long bones
  • Occur in young adults (second and third decades)
  • Usually located in the tibia

References

  1. 1.0 1.1 Kitsoulis P, Galani V, Stefanaki K, Paraskevas G, Karatzias G, Agnantis NJ, Bai M (2008). "Osteochondromas: review of the clinical, radiological and pathological features". In Vivo (Athens, Greece). 22 (5): 633–46. PMID 18853760.
  2. Peabody, Terrance (2014). Orthopaedic oncology : primary and metastatic tumors of the skeletal system. Cham: Springer. ISBN 9783319073224.
  3. Czerniak, Bogdan (2016). Dorfman and Czerniak's bone tumors. Philadelphia, PA: Elsevier/Saunders. ISBN 9780323023962.
  4. Frassica FJ, Unni KK, Beabout JW, Sim FH (1986). "Dedifferentiated chondrosarcoma. A report of the clinicopathological features and treatment of seventy-eight cases". J Bone Joint Surg Am. 68 (8): 1197–205. PMID 3021775.
  5. Björnsson J, McLeod RA, Unni KK, Ilstrup DM, Pritchard DJ (1998). "Primary chondrosarcoma of long bones and limb girdles". Cancer. 83 (10): 2105–19. PMID 9827715.

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