33F with 2 months pain after running.
I don’t know what to do with this chondroid lesion.
T1w shows that it is limited to the metaphysis, but I think Sag suggests
deep endosteal scalloping.
There is some edema between the trochanter and IT band…which might
explain her pain.
Also looks like a thin posterior cyst…is there a posterior labral tear
(see axials)?
Should I recommend CT? Follow this? Orthop Onc consult? Or is this just an
incidental enchondroma that should be ignored.
Really don’t know.
[image: 1.jpg]
[image: 2.jpg]
[image: 3.jpg]
[image: 4.jpg]
[image: 5.jpg]
I am attaching XRs shared by the orthopedist.
He said that she is a high mileage runner and clinically he suspects stress
fracture.
Since I didn’t see a cortical defect, fracture or periosteal edema, I
thought the subtroch bright PDFS signal was red marrow….but she’s been on
crutches, so maybe it is residual stress related marrow edema.
I’ve gotten responses that range from “enchondroma, no follow up”, to
“follow up imaging (surveillance)”, to get XR, or get CT.
I don’t think we see it well on XR, so I suggested we get CT to look at
the cortex…see if it’s scalloped / thinned. I’ll share those images when
I get them.
[image: image.png]
[gallery]