Osteoid osteomaOsteoid osteomaConsists of newly formed boneConsists of newly formed bone

Clinical featuresClinical features< 30 years age< 30 years ageSevere pain relieved by Aspirin Severe pain relieved by Aspirin

but not by restbut not by restFemur and tibiaFemur and tibia

X-rayX-rayTiny radiolucent area (nidus) Tiny radiolucent area (nidus)

{less than one cm.}{less than one cm.}Round or ovalRound or ovalSurrounded by dense boneSurrounded by dense boneThickened cortexThickened cortex

TreatmentTreatment

Complete removalComplete removal

Chondroma(EnchondroChondroma(Enchondroma)ma)

Clinical featuresClinical features

Young Young Incidentally on X-rayIncidentally on X-rayPathological #Pathological #

X-rayX-ray

Central radiolucentCentral radiolucentExpandedExpandedMetaphysisMetaphysisFlecks of calcificationFlecks of calcification

TreatmentTreatment

Curettage and GraftCurettage and Graft

OsteochondromaOsteochondroma(Cartilage- capped (Cartilage- capped

exostosisexostosis))

Clinical featuresClinical features TeenageTeenage

Lump in the fast-growing ends of the long bones or Lump in the fast-growing ends of the long bones or iliac crestiliac crest

Stops enlarging at the end of the normal growth Stops enlarging at the end of the normal growth period for that bone.period for that bone.

Further enlargement after that means malignant Further enlargement after that means malignant changeschanges

Multiple lesions (Hereditary multiple exostosis)Multiple lesions (Hereditary multiple exostosis)

Solitary 1% }Solitary 1% } Multiple 6%}→MalignantMultiple 6%}→Malignant

X-rayX-rayWell defined bony protuberance Well defined bony protuberance

from the metaphysis of lower from the metaphysis of lower femur or upper tibia or from the femur or upper tibia or from the iliac crestiliac crest

The direction is away from the jointThe direction is away from the joint

It is continuous with the mother It is continuous with the mother bonebone

Looks smaller than it feelsLooks smaller than it feels

The capped cartilage may calcifyThe capped cartilage may calcify

TreatmentTreatment

ExcisionExcision

Simple bone cyst Simple bone cyst (Solitary; Unicameral bone (Solitary; Unicameral bone

cyst)cyst)

Clinical featuresClinical features

Child Child

Incidental finding on X-Incidental finding on X-ray(Proximal humerus OR Femur)ray(Proximal humerus OR Femur)

Pathological #Pathological #

X-rayX-rayLarge bubble inside the Large bubble inside the

metaphysismetaphysisNever extends beyond physial Never extends beyond physial

plateplateNo expansion of the boneNo expansion of the boneMay occupy the entire May occupy the entire

metaphysismetaphysis

TreatmentTreatment AsymptomaticAsymptomatic No treatment(Avoid injury) No treatment(Avoid injury)

Active cystActive cyst1- young child1- young child2- the cyst abutting against the physical 2- the cyst abutting against the physical

plateplate3- enlarging in sequential X-rays3- enlarging in sequential X-rays

Fluid aspiration(straw color)+ Fluid aspiration(straw color)+ injection of 80-160 methylprednisoloninjection of 80-160 methylprednisolon

If still enlarging OR pathological #If still enlarging OR pathological # Curettage + bone graftCurettage + bone graft