Referred by a podiatrist who was looking for cuneocuboid degenerative joint disease or fracture, and indicated clinical symptoms of sinus tarsi syndrome.I have no other imaging….podiatrists often do their own XRs, but I don’t have them.
There is an obvious mineralized eccentric lesion thinning and expanding the medial cortex of the cuboid (there might be subtle pathologic fracture of the thinned, cortex) with smooth pressure erosion of the lateral cuneiform and reactive sclerosis of the cuboid.
There is no infiltration of the sinus tarsi.
I believe this is most likely osteoblastoma….but gave differential of osteoid osteoma and, less likely an indolent chondroid lesion.
Here’s my questions:
1. Can you tell if these are osseous or chondroid matrix calcifications? I know we say that’s what we’re looking for…but I think it’s often impossible to distinguish between these. If anything, this looks more like "arcs"…but it’s not at the end of bone, and the patient is skeletally mature…so it shouldn’t be chondroblastoma, and it seems too indolent to be an aggressive chondroid neoplasm. Do you think this is ossific or chondroid? Can you tell?
2. Is there any reason to recommend MRI….other than wanting to see it?
Hilary
