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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Enchondromas are the most common benign cartilaginous bone tumors arising in the medullary cavity of the small bones of the hand. In contrast, chondrosarcomas, commonly occurring in the pelvis and proximal femur and humerus, are very uncommon at this site. We report an unusual case of chondrosarcoma arising in the ring finger proximal phalanx with its radiological and histological features and reviewed the literature. The patient was an 80-year-old man whose chief complaint was swelling and pain for seven years. The findings of cortical irregular thickening by plain radiography and computed tomography and soft tissue extension by magnetic resonance imaging suggested the tumor was chondrosarcoma rather than a common enchondroma. Thorough curettage and artificial bone grafting was performed because of the age of the patient, his senile dementia and the strong desire of the patient and his family. Histological examination revealed that the tumor was composed of polygonal cells with eosinophilic cytoplasm proliferating in the chondromatous matrix with partially myxoid changes. Nuclear irregularity, binucleated cells, bone permeation and encasement were observed and the tumor was diagnosed as grade 2 chondrosarcoma. The tumor recurred five months after surgery. Amputation of the ring finger including the distal part of the 4th metacarpal was performed. At two years after surgery, the patient was free from recurrence or lung metastasis. In conclusion, details of radiological as well as pathological findings are essential for differential diagnosis between benign enchondroma and chondrosarcoma in the hand. Chondrosarcoma of the hand requires a prompt and more radical treatment than enchondroma. Wide excision is recommended to avoid local recurrence or metastasis.
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PMID:Chondrosarcoma of the ring finger: a case report and review of the literature. 1649 37

160 patients (72 men and 88 women) in the age from 12 to 71 were admitted to Orthopaedic and Traumatology Department Skubiszewski Medical University in Lublin because of enchondromas. In 126 patients chondromas were located in hand, and in 34 remaining patients (21,3%) in: humerus, forearm, femur, tibia, fibula and foot. The typical signs of enchondroma were: pain, little limitation of movement, thickening of tissues or pathological fracture. 31 patients were operated on. Enchondroma was resected with cutterage, the walls of osseus cavity cleaned with reamer and bone loss filled up with bone grafts or bone cement. 1 case of recurrence of chondroma of toe was noted. In one patent malignant change of chondroma of proximal metaphysis of tibia to chondrosarcoma was observed. Lesion resection and filling up the bone defect is the best method of treatment of enchondroma.
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PMID:[Clinical signs and methods of treatment of enchondromas located outside the hand]. 1661 64

Dedifferentiated chondrosarcoma (DDCS) comprises approximately 10% of all chondrosarcomas and has the worst outcome with 5-year survival of 10%. The preferred localizations are femur, humerus and pelvis. We report a case of DDCS that arose in proximal phalanx of left-hand thumb of a 66-year-old man. He was admitted with a 2-month history of pain and swelling in his thumb. He had experienced a fracture 15 years ago in the same localization with a history of suspected preexisting enchondroma. Plain radiographs showed an expansive osteolytic lesion with milimetric calcifications while magnetic resonance imaging revealed intraosseous focal globular hyperintense spots consistent with chondroid areas as well as a surrounding soft tissue mass with intermediate signal intensity. In biopsy specimen we observed a low-grade chondrosarcoma next to a spindle cell sarcoma with an abrupt transition. He was treated with amputation and died of the disease within 9 months following the surgery. The presence of dedifferented chondrosarcoma in bones of hands was not previously reported. The presented case was provided with the macroscopic and microscopic features observed in amputation specimen in comparison with radiological findings.
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PMID:Dedifferentiated chondrosarcoma of the thumb: a case report. 1806 60

Enchondroma is the most frequent benign tumor in hand bones. It occasionally occurs in the distal phalanx of the fingers; it is usually an asymptomatic lesion, but pain may occur when it is associated with a fracture. The most recommended treatment is lesion curettage and application of a bone graft, besides fixation as needed. Five cases with location in the distal phalanx are reported, as well as treatment results from January 1978 to May 2010. Of the 5 patients, 4 were females and one was male. The most frequently affected digit was the middle finger followed by the little finger. The most frequent symptom at the time of diagnosis was pain. Lesion curettage was performed in all cases, with the use of an autologous distal radius bone graft in 4 and coralline graft in one. Mean follow-up was 193 months (2-384 months). No complications or relapses were reported.
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PMID:[Enchondroma of the distal phalanx]. 2251 2

Introduction. Enchondroma protuberans is an extremely rare benign cartilaginous bone tumor. We report the first case report of enchondroma protuberans in the forearm. Presentation of Case. We report a case of enchondroma protuberans originating in the left ulnar bone of a young woman. A 20-year-old female referred to our hospital complaining of progressive sustained left forearm pain with a radiation to fourth and fifth finger. Conventional radiography revealed a well-defined eccentric osteolytic lesion in the distal diaphysis of ulna with expansion of overlying cortex (without calcification). Magnetic resonance imaging showed a well-defined ovoid intramedullary lesion, which was exophytically protruding from medial surface of left ulnar bone. Histopathology confirmed the diagnosis. Discussion. Enchondroma protuberans typically present as a well-defined intramedullary osteolytic lesion that may be accompanied by a fine matricidal calcification. The connection between the intramedullary portion and the exophytic protrusion can be seen well by magnetic resonance imaging. Conclusion. Enchondroma protuberans should be considered in the differential diagnosis of osteochondroma, enchondroma, and periosteal chondroid tumors.
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PMID:Enchondroma protuberans of ulnar bone: a case report and review of literature. 2305 Jan 85

Less than 10% of chondrosarcomas occur in children. In addition, as little as 0.5% of low-grade chondrosarcomas arise secondarily from benign chondroid lesions. The presence of focal pain is often used to crudely distinguish a chondrosarcoma (which is usually managed with wide surgical excision), from a benign chondroid lesion (which can be followed by clinical exams and imaging surveillance). Given the difficulty of localizing pain in the pediatric population, initial radiology findings and short-interval follow-up, both imaging and clinical, are critical to accurately differentiate a chondrosarcoma from a benign chondroid lesion. To our knowledge, no case in the literature discusses a chondrosarcoma possibly arising secondarily from an enchondroma in a pediatric patient. We present a clinicopathologic and radiology review of conventional chondrosarcomas. We also attempt to further the understanding of how to manage a chondroid lesion in the pediatric patient with only vague or bilateral complaints of pain.
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PMID:Chondrosarcoma in childhood: the radiologic and clinical conundrum. 2336 1

This trial aimed to assess the value of MRI in the differential diagnosis of chronic groin pain in athletes, a condition caused by various pathologies, the most common being posterior abdominal wall deficiency, osteitis pubis and muscular imbalance. Nineteen subjects with clinically ruled-out hernia and recurrent episodes of exercise-triggered groin pain were assessed. Dynamic MRI was performed under Valsalva manoeuver and at rest within a training- free period and after training activity. Follow-up was performed after 4 years using a questionnaire and physical examination. An incipient hernia was seen in one case, Valsalva manoeuver provoked a visible bulging in 7 others (3 bilateral). Eight athletes showed symphysitis (accompanied by bulging in 3 cases). MRI visualized one hydrocele, one osteoma of the left femur, one enchondroma of the pubic bone, and one dilated left ureter without clinical symptoms or therapeutic relevance. MRI findings after training and during the training free period did not vary. Fifteen participants were available for a follow-up control examination 4 years later - one suffered from ongoing pain, eleven were free of symptoms and three had improvement. However, most of them improved only with changing or reducing training. There were four participants with a specific therapy of their MRI findings. MRI revealed a variety of pathological findings in athletes suffering from chronic groin pain, but it was not reliable enough in differentiating between diagnoses requiring conservative or operative treatment. The MRI examination within the training interval did not have an advantage to that within the training-free period. Further randomized prospective trials with a long follow-up should establish whether MRI findings could be of help in the choice between conservative and surgical treatment for chronic groin pain. Key pointsMRI findings after training and during the train free period did not vary.MRI revealed a variety of pathological findings in athletes suffering from chronic groin pain, but it was not reliable enough in differentiating between diagnoses requiring conservative or operative treatment.
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PMID:MRI Findings Do not Correlate with Outcome in Athletes with Chronic Groin Pain. 2414 27

Occasionally patients who undergo magnetic resonance imaging for presumed pelvic disease demonstrate unexpected musculoskeletal imaging findings in the imaged field. Such incidental findings can be challenging to the abdominal radiologist, who may not be familiar with their appearance or know the appropriate diagnostic considerations. Findings can include both normal and abnormal bone marrow, osseous abnormalities such as Paget's disease, avascular necrosis, osteomyelitis, stress and insufficiency fractures, and athletic pubalgia, benign neoplasms such as enchondroma and bone island, malignant processes such as metastasis and chondrosarcoma, soft tissue processes such as abscess, nerve-related tumors, and chordoma, joint- and bursal-related processes such as sacroiliitis, iliopsoas bursitis, greater trochanteric pain syndrome, and labral tears, and iatrogenic processes such as bone graft or bone biopsy. Though not all-encompassing, this essay will help abdominal radiologists to identify and describe this variety of pelvic musculoskeletal conditions, understand key radiologic findings, and synthesize a differential diagnosis when appropriate.
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PMID:MR imaging of the pelvis: a guide to incidental musculoskeletal findings for abdominal radiologists. 2468 26

A 55-year-old man underwent MRI for right hemifacial pain, which demonstrated a heterogeneously enhancing lesion in right clivus. The lesion was characterized as enchondroma on CT images, which demonstrated increased tracer uptake on PET-CT images. The chondroid matrix showed increased glucose metabolism with no significant enhancement on MRI, suggesting a perfusion-metabolism mismatch.
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PMID:Enchondroma of clivus: appearance on 18F-FDG PET-CT in contrast with MRI. 2548 53

Enchondromas are benign bone tumours originating from cartilages. It is mainly discovered incidentally in radiographs or due to symptoms like pathological fracture or pain. Conservative treatment through regular check-up and surgical excision using curettage are the two major treatment methods for enchondromas. This review concludes that small localized asymptomatic lesions can be treated conservatively while most expanding or symptomatic lesions should be treated with simple curettage. Adjuvant treatments like high-speed burring or alcohol instillation are not recommended.
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PMID:Current management of hand enchondroma: a review. 2560 98


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