Periosteal chondroma of the proximal tibia mimicking Osgood-schlatter’s disease

T Vancauwenberghe,Fm Vanhoenacker,H Declercq,J Van Doninck

doi:10.5334/jbr-btr.178

T Vancauwenberghe, Fm Vanhoenacker + Show 2 more

Open Access

https://doi.org/10.5334/jbr-btr.178

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Abstract

We report a case of a periosteal chondroma of the proximal tibia in an 11-year-old girl, which was initially misdiagnosed as Osgood-Schlatter's disease. The absence of pain and meticulous analysis of the imaging findings on initial and follow-up plain radiographs, ultrasound and MRI allowed to suggest the diagnosis of a periosteal chondroma, which was confirmed after biopsy. Besides the difficulty in the imaging diagnosis of the lesion, determination of the optimal treatment strategy may be challenging as well. Given the localization of this lesion close to the growth plate, decision has to be made whether the lesion will be treated surgically or a waitful watching policy will be implemented in order to prevent interference with the normal growth of the bone.

Highlights

We report a case of a periosteal chondroma of the proximal tibia in an 11-year-old girl, which was initially misdiagnosed as Osgood-Schlatter’s disease
When the lesion is located at the proximal tibia adjacent to the unfused apophysis of tibial tuberosity (TT), the diagnosis can be challenging, because of its radiological resemblance to Osgood-Schlatter’s disease
The purpose of this paper is to report the distinctive clinical and imaging features allowing a correct diagnosis of this unusual lesion in order to initiate appropriate treatment

Summary

Case report

An 11-year-old healthy girl presented with a painless firm swelling at the anterior aspect of the left proximal tibia. The lesion was initially interpreted as OsgoodSchlatter’s disease and relative rest was recommended. Nine months later, she was readmitted with a slightly grown swelling. Magnetic lesion demonstrated thickening no thickening of the distal patellar resonance imaging (MRI) was perof the cortex at its proximal and tendon (Fig. 3). These findings argue formed for further lesion characteridistal margins, in keeping with a against the diagnosis of Osgood- zation, which revealed a juxtacortical “cortical buttress sign” (Fig. 2).

Discussion

Conclusion