EURORAD ESR

Case 14513

Chondroblastoma of the proximal tibia

Author(s)
Alexander Favril1, Ivan Pilate2, Peter Brys1, Filip Vanhoenacker2, 3, 4

1. University Hospital Leuven,
Department of Radiology;
Herestraat 49, 3000 Leuven, Belgium
2. AZ Sint-Maarten Duffel-Mechelen, D
epartment of Radiology;
Leopoldstraat 2, 2800 Mechelen, Belgium
3. University Hospital Antwerp,
Department of Radiology;
Wilrijkstraat 10, 2650 Antwerp, Belgium
4. University of Ghent,
Faculty of Medicine and Health Sciences;
De Pintelaan 185, 9000 Ghent, Belgium.
 
Patient
male, 13 year(s)
 
 
  • Figure 1
    MRI of the right knee
     

    Sagittal T1-WI. On T1-WI the lesion is isointense to muscle and is partially surrounded by a hypointense border (red arrow), corresponding with a sclerotic rim on CT.

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Neoplasia;

    Sagittal fat-suppressed (FS) T2-WI. On T2-WI the lesion is inhomogeneous, hyperintense with interspersed areas of low signal intensity. The lesion is relatively well-demarcated and has a hypointense rim (red arrows).

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Neoplasia;

    Coronal FS T2-WI. There was suspicion of breakthrough of the articular cortex (Fig.1c) and the posterior cortex of the proximal tibia (Fig.1b)(white arrows).

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Neoplasia;

    Axial FS T2-WI. Note the marked surrounding bone marrow oedema (white asterisks). There is an overall lobular structure of the lesion.

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Neoplasia;
     
     
  • Figure 2
    Plain radiography of the right knee
     

    The PA view showed a subtle translucent area within the proximal tibial epiphysis which was only visible after careful correlation with MRI.

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: Plain radiographic studies; Procedure: Screening; Special Focus: Neoplasia;

    Lateral view. A barely visible osteolytic lesion in the posterior tibial epiphysis can be suspected. Note also subtle loss of cortical outline of the dorsal and articular cortex (white arrows).

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: Plain radiographic studies; Procedure: Screening; Special Focus: Neoplasia;
     
     
  • Figure 3
    CT of the right knee
     

    Sagittal reformatted CT image. The lesion is well-demarcated by a partial sclerotic rim (red arrow). There is however marked thinning of the articular and the posterior cortex with subtle cortical breakthrough (white...

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Neoplasia;

    Coronal reformatted CT image. Note breakthrough at the articular cortex.

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Neoplasia;

    Axial CT image. Note subtle intralesional calcifications (red arrows), in keeping with chondroid matrix.

     
    Area of Interest: Musculoskeletal bone; Imaging Technique: MR; Procedure: Imaging sequences; Special Focus: Neoplasia;
     
     
Sagittal T1-WI. On T1-WI the lesion is isointense to muscle and is partially surrounded by a hypointense border (red arrow), corresponding with a sclerotic rim on CT.
 
Sagittal fat-suppressed (FS) T2-WI. On T2-WI the lesion is inhomogeneous, hyperintense with interspersed areas of low signal intensity. The lesion is relatively well-demarcated and has a hypointense rim (red arrows).
 
Coronal FS T2-WI. There was suspicion of breakthrough of the articular cortex (Fig.1c) and the posterior cortex of the proximal tibia (Fig.1b)(white arrows).
 
Axial FS T2-WI. Note the marked surrounding bone marrow oedema (white asterisks). There is an overall lobular structure of the lesion.
 
The PA view showed a subtle translucent area within the proximal tibial epiphysis which was only visible after careful correlation with MRI.
 
Lateral view. A barely visible osteolytic lesion in the posterior tibial epiphysis can be suspected. Note also subtle loss of cortical outline of the dorsal and articular cortex (white arrows).
 
Sagittal reformatted CT image. The lesion is well-demarcated by a partial sclerotic rim (red arrow). There is however marked thinning of the articular and the posterior cortex with subtle cortical breakthrough (white arrows).
 
Coronal reformatted CT image. Note breakthrough at the articular cortex.
 
Axial CT image. Note subtle intralesional calcifications (red arrows), in keeping with chondroid matrix.
 
 
 
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