chondrogenic tumor composed of hyaline cartilage
located in the medullary cavity
caused by an abnormality of chondroblast function in the physis
male:female ratio is 1:1
20-50 year olds
most common location is the hand
medullary cavity of the diaphysis or metaphysis
other locations of distal femur, proximal humerus, tibia
solitary enchondroma
Ollier’s disease
maffucci’s syndrome
sporadic inheritance with no genetic predisposition
skeletal dysplasia with failure of normal endochondral ossification
enchondromas throughout the metaphyses and diaphyses of long bones
involved bones are dysplastic, with shortening and bowing
risk of malignant transformation <30%
sporadic inheritance with * no genetic predisposition *
multiple enchondromas and soft-tissue angiomas
radiographically, enchondromas in Maffucci’s syndrome markedly expand the bone and angiomas are seen as small, round calcified phleboliths
*risk of malignant transformation up to 100% *
also has increased risk of visceral malignancies (astrocytoma, GI malignancy)
metaphyseal location when they first appear
appear more diaphyseal as the long bone grows
“pop-corn” stippled calcification and rings
cortical expansion and thinning may be present (especially in the hand)
cortical thickening and destruction
endosteal erosions and scalloping >50% of the width of the cortex
are larger (>5cm)
bone infarct — smoke up chimney
chondrosarcoma
serial radiographs for interval growth
long term followup for patients with multiple enchondroma
immobilization, followed by currettage and bone grafting
immobilize until fracture union, followed by currettage and grafting
cortical thickening and destruction
endosteal erosions and scalloping >50% of the width of the cortex
are larger (>5cm)
