Question:

Which of these answers on Enchondromatosis imaging is true?
1. Radiography shows dense, heterogeneous lesions.
2. It is not possible to see dystrophic calcifications on radiographs.
3. Ground glass appearance of the matrix is a typical finding on radiographs.
4. On MRI non mineralized component of enchondromas has high signal on T1-w sequences.
5. Bone infarct is not included in differential diagnosis on imaging.





Answer:

The correct answer for the question "Which of these answers on Enchondromatosis imaging is true?" is:

3. Ground glass appearance of the matrix is a typical finding on radiographs.



Explanation
1. [Radiography typically shows multiple, radiolucent, homogenous lesions with an ovalar or elongated shape.]

2. [Dystrophic calcifications within the matrix of small cartilage nodules or fragments of lamellar bone are often described.]

3. [Radiography  typically  shows  multiple,  radiolucent,  homogenous  lesions  with  an ovoid or elongated shape, endosteal erosion and ground glass appearance of the matrix.]

4. [The non-mineralized component of enchondromas has low to intermediate signal intensity on T1-w sequences.]

5. [On imaging, differential diagnoses include bone infarct, chondrosarcoma, epidermoid inclusion cyst, unicameral bone cyst, giant cell tumor and fibrous dysplasia.]



From the manuscript:
A rare case of Enchondromatosis of the knees and hands with involvement of Hoffa`s fat pad and peri-articular soft-tissues
Radiology Case. 2013 Jun; 7(6):22-30


This article belongs to the MSK section.




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From the manuscript

A rare case of Enchondromatosis of the knees and hands with involvement of Hoffa`s fat pad and peri-articular soft-tissues

Free full text article: A rare case of Enchondromatosis  of the knees and hands with involvement of Hoffa`s fat pad and peri-articular soft-tissues

Abstract
We report a case of a 56-year old man with chronic pain in both knees for several years. This patient had already undergone surgery on his left knee in 2002 after an x-ray showed multiple lytic and well margined lesions in the distal femur and proximal tibia with ground-glass matrix, involving Hoffa`s fat pad and the patellar ligament. Histology was consistent with an enchondroma. The most recent MRI examination showed enchondromatosis involving both knees with bilateral extension into Hoffa`s fat pad and the patellar ligament. Subsequently, we performed an additional radiographic examination of the hands and feet, as well as an MRI of both hands to identify other possible enchondromas in the most common sites for this disease. Enchondromatosis with soft tissue involvement is extremely rare, and involvement of Hoffa`s fat pad has not been reported in the scientific literature. The clinical presentation of this case and the general aspects of Enchondromatosis are discussed.






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