Hand radiograph shows multiple lucent lesions in the majorit | Figure 1

CincyKidsRad

Cincinnati Children's Radiology

Hand radiograph shows multiple lucent lesions in the majority of metacarpals and bones of the fingers. The lesions are all lucent, mildly expansile, and contain a ground glass matrix typical of enchondromas. Patients with multiple enchondromas are said to have Ollier disease. Patients with Ollier disease have a 25% risk of developing chondrosarcoma by age 40. #MSKMonday

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Hand radiograph shows a pathologic fracture of the proximal phalanx of the right ring finger. The fracture is occurring through an enchondroma. Enchondromas are the most common bone tumor of the hand. They are benign lesions and, in the hand, appear lucent and expansile with a ground-glass or smudgy matrix. Enchondromas in other parts of the body have a different internal matrix with calcification in a “rings and arcs” pattern. #MSKMonday #MusculoskeletalMonday

AP radiograph of the hand shows multiple expansile lucent lesions affecting many of the bones of the hand, In addition to the bone lesions, there is irregularity of the soft issues including multiple calcifications. These findings are typical of Maffucci syndrome. Maffucci syndrome is characterized by multiple enchondromas and vascular malformations. The calcifications seen in the soft tissues represent phleboliths within the dilated vascular spaces. Patients with Maffucci syndrome have a high risk (up to 50%) of developing chondrosarcoma from malignant degeneration of one of the enchondromas. #MSKMonday #MusculoskeletalMonday

AP and lateral radiographs of the right ring finger shows multiple expansile lucent lesions of the metacarpal and phalanges of the ring finger consistent with multiple enchondromas. Ollier disease is a dysplasia involving multiple enchondromas. The disease typically is unilateral or has an asymmetric distribution. Patients with Ollier disease have a 25% risk of developing chondrosarcoma by age 40. Other diseases with lucent lesions affecting multiple bones include Langerhans' cell histiocytosis and fibrous dysplasia.

Radiograph of the hand in the same patient shows an expansile lucent lesion of the middle phalanx of the index finger. A second lesion is also present in the proximal phalanx of the same finger. The differential diagnosis for these findings is polyostotic fibrous dysplasia (this case) or multiple enchondromas (Ollier disease). When polyostotic fibrous dysplasia is associated with premature puberty and café au lait spots, it is termed McCune-Albright syndrome. #FridayQuizDay