Osteochondroma differential diagnosis

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.

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.

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